Association of Infant Antibiotic Exposure With Childhood Health Outcomes.
Level 3 - non-randomized controlled study
Retrospective population-based cohort study using linked medical records.
PubMed 33208243 · doi:10.1016/j.mayocp.2020.07.019
What was done
A population-based cohort study analyzed 14,572 children born in Olmsted County, Minnesota between January 1, 2003, and December 31, 2011, using the Rochester Epidemiology Project medical records-linkage system. Researchers collected demographic details, antibiotic prescriptions during the first 2 years of life, and diagnostic codes through June 30, 2017, conducting time-to-event analyses to evaluate associations with childhood-onset health conditions.
What was found
Of 14,572 children (7,026 girls and 7,546 boys), 70% (10,220) received at least one antibiotic prescription in their first 2 years. Early exposure was significantly associated with higher risks of asthma, allergic rhinitis, atopic dermatitis, celiac disease, overweight, obesity, and attention deficit hyperactivity disorder, with hazard ratios ranging from 1.20 to 2.89 (P < .05 for all). Risk increased with multiple prescriptions and varied by antibiotic class and timing of exposure.
Why it matters
This study links early-life antibiotic use to a broad spectrum of chronic childhood conditions, supporting the need for antimicrobial stewardship in infants.
Limits
The study is observational and vulnerable to confounding by indication, as underlying infections could contribute to long-term health risks. Individual hazard ratios, confidence intervals, and specific adjustment covariates are not reported in the abstract, and results from Olmsted County may not generalize to diverse populations.
Cited by
- supports Repeated exposure to antibiotics early in life increases the likelihood of developing allergies and autoimmunity.