Study finds antibiotics before age two associated with childhood health issues

Nov. 16, 2020

Children under age two who take antibiotics are at greater risk for childhood-onset asthma, respiratory allergies, eczema, celiac disease, obesity and attention deficit hyperactivity disorder, according to a paper written jointly by Mayo Clinic and Rutgers researchers, reported Mayo Clinic. 

In a study published in the journal Mayo Clinic Proceedings, the researchers looked at 14,572 children born in Olmsted County, Minn., between 2003 and 2011, 70 percent of whom received at least one antibiotic prescription during their first two years, primarily for respiratory or ear infections. The findings are consistent with the hypothesis that the composition of the microbiome - the trillions of beneficial microorganisms that live in and on our bodies - plays a critical role in the early development of immunity, metabolism and behavior.

"The evolution of drug-resistant bacteria exemplifies one unintended consequence of antibiotic overuse," said co-author Martin Blaser, director of the Center for Advanced Biotechnology and Medicine at Rutgers. "The increasing prevalence of health conditions that start in childhood has triggered concern about antibiotic exposures during key developmental periods because of their impact on the microbiome."

While previous studies have looked at the association of antibiotics with single diseases, this is the first to look at the association across many diseases. The study found that antibiotics were associated with metabolic diseases (obesity, being overweight), immunological diseases (asthma, food allergies, hay fever and cognitive conditions or disorders (ADHD, autism), but effects varied among the different antibiotics. Cephalosporins were associated with the most risk for multiple diseases, and uniquely autism and food allergies.

Researchers also found that risk increased with more courses of antibiotics and when given earlier in life -- especially within the first six months.

"The findings from Olmsted County provide evidence for broad and delayed effects of early life antibiotic exposures and should change doctors' practices in how often they prescribe antibiotics, especially for mild conditions," said Blaser.

To investigate the extent to which antibiotic exposure in the first two years of life is associated with the risk of immunological, metabolic, and neurobehavioral health conditions with childhood onset.

This study included 14,572 children (7,026 girls and 7546 boys), of whom 70 percent (10,220) received at least one antibiotic prescription during the first two years of life. Early antibiotic exposure was associated with an increased risk of childhood-onset asthma, allergic rhinitis, atopic dermatitis, celiac disease, overweight, obesity, and attention deficit hyperactivity disorder (hazard ratios ranging from 1.20 to 2.89; for all). The associations were influenced by the number, type, and timing of antibiotic exposure. Moreover, children exposed to antibiotics had a higher probability of having combinations of conditions, particularly when given multiple prescriptions.

The present study finds significant associations between early life antibiotic exposure and several distinct health conditions with childhood onset. Additional research is warranted to establish practical guidelines to optimize the benefit and minimize the risk of antibiotics in children.

Mayo Clinic has the article.