 This systematic review found that antibiotics reduced the diversity of the infant kept microbiome in low and middle-income countries will mix, while also increasing the presence of antibiotic-resistant genes. This suggests that antibiotic use may be contributing to the development of antibiotic resistance in these regions. Further research is needed to determine if this reduction in microbiome diversity and increase in antibiotic-resistant genes puts LMIC children at greater risk for adverse health outcomes, such as infections with antibiotic-resistant bacteria. This article was authored by Charlie C. Lukhen, Muelva Chibiwi, Rene Spijker, and others.