Daniel Honeychurch, Class of 2023
Could antibiotic treatment as an infant be responsible for asthma, allergies, obesity, ADHD, and many more health conditions years later? A new study published in Mayo Clinic Proceedings found a significant increase in a variety of health conditions in children who were exposed to antibiotics as an infant. This study of over 14,000 children compared the participants’ childhood medical conditions with the frequency, timing, and type of antibiotic treatments they received when under the age of two. Incidents of metabolic, immunological, and neurobehavioral childhood health conditions were more prevalent in children exposed to more antibiotic treatments in their first couple years of life (2).
The study’s first goal was to investigate whether one or more antibiotic treatments were linked to a higher frequency of certain health conditions. Occurrences of ADHD, allergic rhinitis, asthma, and overweight were higher for boys and girls exposed to antibiotics as infants. Incidents of obesity were also higher for boys exposed to antibiotics, and rates of celiac disease and atopic dermatitis increased for girls prescribed antibiotics (2).
After associating any antibiotic treatment to an increase in specific health conditions, the researchers studied the effects of multiple antibiotic exposures. Girls who received one or two antibiotic prescriptions had a higher occurrence of celiac disease and asthma, compared to girls with no antibiotic treatment. When the number of antibiotic prescriptions increased, more health conditions became linked to antibiotics. Rates of asthma, overweight, and atopic dermatitis all increased for girls and boys exposed to three or four prescriptions of antibiotics. Celiac disease and ADHD also increased for girls, while boys had an increase in obesity. The highest level of antibiotic exposure studied was five or more prescriptions, and this amount of exposure was linked to the most health conditions. The risk of obesity, ADHD, overweight, asthma, and allergic rhinitis increased for children with five or more antibiotic exposures as an infant. Girls also had an increased risk of celiac disease. Other health conditions studied including food allergies, autism, and learning disability did not have a significant increase for boys or girls with any level of antibiotic exposure (2). This analysis only considered the number of different antibiotic exposures, although it is recognized that the strength of doses may also affect the health outcomes.
The study also analyzed the association of specific health conditions to four types of antibiotics: penicillin, cephalosporins, sulfonamides, and macrolides. For boys, penicillin was linked with a higher rate of asthma, overweight, and obesity. For girls, penicillin was linked to a higher occurrence of asthma, overweight, ADHD and celiac disease, but a lower rate of autism. Girls and boys both had cephalosporins associated with higher occurrences of asthma, allergic rhinitis, food allergy, and autism. Girls exposed to cephalosporins also had an increase in atopic dermatitis and obesity, while boys had an increase in overweight and learning disability. Boys in the study had sulfonamides correlated with a higher rate of overweight, but girls had no health conditions linked to this type of antibiotic. Risk of asthma and overweight increased for both girls and boys exposed to macrolides. Boys also had an increase in obesity and allergic rhinitis but had a decreased risk of learning disability, while girls had a decreased risk of atopic dermatitis (2). Different types of antibiotic treatments affected the children differently, with some increasing or decreasing certain health conditions based on sex. Considering the exact types of antibiotics that may be harmful is important to determine if some treatments are safer than others.
Antibiotics are prescribed to treat bacterial infections by killing or preventing harmful bacteria from spreading in the human body. Common illnesses often requiring antibiotics include whooping cough, strep throat, urinary tract infections, and sepsis (1). Although antibiotics save people’s lives, these treatments have many side effects since they can inadvertently harm the trillions of beneficial microorganisms living in the human body. These organisms live in most parts of our body, including the intestinal tract, lungs, skin, and nose. Microorganisms not only live in our bodies but have many vital functions. For example, microbes living amongst our intestinal cells digest carbohydrates, proteins, and lipids that we eat, but cannot digest. This aid in digestion unlocks more nutrients and vitamins for our bodies (4). With the many benefits of our microbiomes, we should be aware of possible physiological disturbances caused by antibiotics.
Previous research has found similar findings relating antibiotics to an increased risk of obesity. A study published in BMJ Journals in 2018 analyzed the records of over 300,000 children. The researchers found that children prescribed with antibiotics when under the age of two had a 26% increased chance of childhood obesity (3). The Centers for Disease Control (CDC) advises physicians not to prescribe antibiotics for viral illnesses or certain bacterial infections, including some ear infections or sinus infections. In cases when antibiotics are necessary, the CDC warns to prescribe the correct dose and length of treatment, to limit the overuse of antibiotics (1).
This new research only establishes a correlation between antibiotics and many childhood health conditions, and more research is necessary to determine if antibiotics given to infants is causing this increased risk. Nonetheless, this research is important in providing hypotheses that can be tested in future studies. Antibiotics are important in medicine, but research shows that medical professionals should be cautious in prescribing antibiotics to infants. The human microbiome is important for our health, and more research in the future may clarify the effect of antibiotics on infants’ microbes and that effect on their future health conditions.
References
1. Antibiotic Use Questions and Answers. 2019 Oct 31. Centers for Disease Control and Prevention. [accessed 2020 Nov 22]. https://www.cdc.gov/antibiotic-use/community/about/should-know.html
2. Aversa Z, Atkinson EJ, Schafer MJ, Theiler RN, Rocca WA, Blaser MJ, LeBrasseur NK. 2020 Nov 15. Association of Infant Antibiotic Exposure With Childhood Health Outcomes. Mayo Clinic Proceedings.
3. McCarthy C. 2018 Nov 27. Giving babies and toddlers antibiotics can increase the risk of obesity. Harvard Health Publishing. [accessed 2020 Nov 22]. https://www.health.harvard.edu/blog/giving-babies-and-toddlers-antibiotics-can-increase-the-risk-of-obesity-2018113015477
4. NIH Human Microbiome Project defines normal bacterial makeup of the body. 2015 Aug 31. National Institutes of Health. [accessed 2020 Nov 22]. https://www.nih.gov/news-events/news-releases/nih-human-microbiome-project-defines-normal-bacterial-makeup-body
Image: https://pixnio.com/science/medical-science/baby-was-receiving-his-scheduled-vaccine-injection-in-his-right-thigh-muscle-ie-intramuscular-injection
The study’s first goal was to investigate whether one or more antibiotic treatments were linked to a higher frequency of certain health conditions. Occurrences of ADHD, allergic rhinitis, asthma, and overweight were higher for boys and girls exposed to antibiotics as infants. Incidents of obesity were also higher for boys exposed to antibiotics, and rates of celiac disease and atopic dermatitis increased for girls prescribed antibiotics (2).
After associating any antibiotic treatment to an increase in specific health conditions, the researchers studied the effects of multiple antibiotic exposures. Girls who received one or two antibiotic prescriptions had a higher occurrence of celiac disease and asthma, compared to girls with no antibiotic treatment. When the number of antibiotic prescriptions increased, more health conditions became linked to antibiotics. Rates of asthma, overweight, and atopic dermatitis all increased for girls and boys exposed to three or four prescriptions of antibiotics. Celiac disease and ADHD also increased for girls, while boys had an increase in obesity. The highest level of antibiotic exposure studied was five or more prescriptions, and this amount of exposure was linked to the most health conditions. The risk of obesity, ADHD, overweight, asthma, and allergic rhinitis increased for children with five or more antibiotic exposures as an infant. Girls also had an increased risk of celiac disease. Other health conditions studied including food allergies, autism, and learning disability did not have a significant increase for boys or girls with any level of antibiotic exposure (2). This analysis only considered the number of different antibiotic exposures, although it is recognized that the strength of doses may also affect the health outcomes.
The study also analyzed the association of specific health conditions to four types of antibiotics: penicillin, cephalosporins, sulfonamides, and macrolides. For boys, penicillin was linked with a higher rate of asthma, overweight, and obesity. For girls, penicillin was linked to a higher occurrence of asthma, overweight, ADHD and celiac disease, but a lower rate of autism. Girls and boys both had cephalosporins associated with higher occurrences of asthma, allergic rhinitis, food allergy, and autism. Girls exposed to cephalosporins also had an increase in atopic dermatitis and obesity, while boys had an increase in overweight and learning disability. Boys in the study had sulfonamides correlated with a higher rate of overweight, but girls had no health conditions linked to this type of antibiotic. Risk of asthma and overweight increased for both girls and boys exposed to macrolides. Boys also had an increase in obesity and allergic rhinitis but had a decreased risk of learning disability, while girls had a decreased risk of atopic dermatitis (2). Different types of antibiotic treatments affected the children differently, with some increasing or decreasing certain health conditions based on sex. Considering the exact types of antibiotics that may be harmful is important to determine if some treatments are safer than others.
Antibiotics are prescribed to treat bacterial infections by killing or preventing harmful bacteria from spreading in the human body. Common illnesses often requiring antibiotics include whooping cough, strep throat, urinary tract infections, and sepsis (1). Although antibiotics save people’s lives, these treatments have many side effects since they can inadvertently harm the trillions of beneficial microorganisms living in the human body. These organisms live in most parts of our body, including the intestinal tract, lungs, skin, and nose. Microorganisms not only live in our bodies but have many vital functions. For example, microbes living amongst our intestinal cells digest carbohydrates, proteins, and lipids that we eat, but cannot digest. This aid in digestion unlocks more nutrients and vitamins for our bodies (4). With the many benefits of our microbiomes, we should be aware of possible physiological disturbances caused by antibiotics.
Previous research has found similar findings relating antibiotics to an increased risk of obesity. A study published in BMJ Journals in 2018 analyzed the records of over 300,000 children. The researchers found that children prescribed with antibiotics when under the age of two had a 26% increased chance of childhood obesity (3). The Centers for Disease Control (CDC) advises physicians not to prescribe antibiotics for viral illnesses or certain bacterial infections, including some ear infections or sinus infections. In cases when antibiotics are necessary, the CDC warns to prescribe the correct dose and length of treatment, to limit the overuse of antibiotics (1).
This new research only establishes a correlation between antibiotics and many childhood health conditions, and more research is necessary to determine if antibiotics given to infants is causing this increased risk. Nonetheless, this research is important in providing hypotheses that can be tested in future studies. Antibiotics are important in medicine, but research shows that medical professionals should be cautious in prescribing antibiotics to infants. The human microbiome is important for our health, and more research in the future may clarify the effect of antibiotics on infants’ microbes and that effect on their future health conditions.
References
1. Antibiotic Use Questions and Answers. 2019 Oct 31. Centers for Disease Control and Prevention. [accessed 2020 Nov 22]. https://www.cdc.gov/antibiotic-use/community/about/should-know.html
2. Aversa Z, Atkinson EJ, Schafer MJ, Theiler RN, Rocca WA, Blaser MJ, LeBrasseur NK. 2020 Nov 15. Association of Infant Antibiotic Exposure With Childhood Health Outcomes. Mayo Clinic Proceedings.
3. McCarthy C. 2018 Nov 27. Giving babies and toddlers antibiotics can increase the risk of obesity. Harvard Health Publishing. [accessed 2020 Nov 22]. https://www.health.harvard.edu/blog/giving-babies-and-toddlers-antibiotics-can-increase-the-risk-of-obesity-2018113015477
4. NIH Human Microbiome Project defines normal bacterial makeup of the body. 2015 Aug 31. National Institutes of Health. [accessed 2020 Nov 22]. https://www.nih.gov/news-events/news-releases/nih-human-microbiome-project-defines-normal-bacterial-makeup-body
Image: https://pixnio.com/science/medical-science/baby-was-receiving-his-scheduled-vaccine-injection-in-his-right-thigh-muscle-ie-intramuscular-injection
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