Childhood Antibiotic Use Linked to Increased Health Risks

TOPLINE:

Children who received multiple antibiotic courses between birth and 2 years of age had a higher risk of developing asthma, food allergies, allergic rhinitis, and intellectual disability, according to a new study. 

METHODOLOGY:

• Researchers analyzed data from a large nationally representative population to examine the associations between antibiotic exposure patterns within 2 years after birth and diagnoses of chronic pediatric conditions.
• Overall, data from 685,665 children (53.4% girls) who were exposed to antibiotics within 2 years of birth were analyzed.
• Researchers grouped outcomes into three categories — asthma and allergic conditions, autoimmune disorders, and neurodevelopmental and psychiatric issues — and tracked them from 27 months to 12 years of age.
• They utilized both conventional cohort and sibling-matched designs to examine the associations, adjusting for a wide range of prenatal and early childhood confounders.

TAKEAWAY:

• Overall, antibiotic exposure before 2 years of age was associated with an increased risk for asthma (adjusted hazard ratio [aHR], 1.24; 95% CI, 1.22-1.26) and food allergy (aHR, 1.33; 95% CI, 1.26-1.4src), with similar results seen in sibling-matched analyses.
• The risk was even higher among children who received five or more antibiotic courses, showing stronger associations for both asthma (aHR, 1.52; 95% CI, 1.49-1.55) and food allergy (aHR, 1.53; 95% CI, 1.42-1.64) than those seen in children who received only one or two courses.
• Additionally, in early childhood, exposure to five or more antibiotics courses was associated with a higher risk for intellectual disability than exposure to one or two courses (aHR, 1.73; 95% CI, 1.49-2.src1).
• No significant associations were found between specific antibiotic classes and autoimmune outcomes.

IN PRACTICE:

“This study contributes to mounting evidence for long-term harms from early-life antibiotic exposure, underscoring the need for judicious antibiotic use in infancy and early childhood,” the authors wrote.

SOURCE:

Daniel B. Horton, MD, MSCE, with the Institute for Health, Health Care Policy and Aging Research, New Brunswick, New Jersey, was the corresponding author of the study, which was published online on April 16 in The Journal of Infectious Diseases.

LIMITATIONS:

The study lacked information on certain potential confounders, including birthweight, ethnicity, and maternal education, raising the possibility of residual confounding. Additionally, the misclassification of prescribed antibiotics and the lack of validation for the intellectual disability outcome could have affected the findings.

DISCLOSURES:

The study was supported through funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Center for Advancing Translational Sciences, and other sources. Several authors declared receiving research funding, consulting fees, honoraria, or salary support from various sources.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.