Children 2 years old and under who take antibiotics are at greater risk for childhood-onset chronic diseases such as asthma, allergies, obesity, and ADHD, according to a new study published in Mayo Clinic Proceedings.
The study joins others that link antibiotic use and overuse with disease in young children, underscoring the need to weigh the prudent use of antibiotics against the harm they inflict on the gut microbiome early in life.
The findings, based on work by researchers at Mayo Clinic and Rutgers University, support the hypotheses that the trillions of symbiotic microorganisms living in and on the body that make up the microbiome shape the early development of immunity, metabolism, behavior, and other critical functions.
Early Antibiotic Exposure and Childhood Health
The population-based study covered all children born in Olmsted County, Minnesota from Jan. 1, 2003, to Dec. 31, 2011.(i) It drew information on antibiotic prescriptions and analyzed the impact of antibiotic exposure on the risk of a few adverse health conditions. The researchers looked at 14,572 children, 70 percent of whom were prescribed at least one antibiotic in the first two years of life, mostly for respiratory or ear infections.
They concluded that early antibiotic exposure was connected with a greater risk of childhood-onset asthma, allergic rhinitis, eczema or dermatitis, Celiac disease, obesity or being overweight, and ADHD—all influenced by the number, type, and timing of the antibiotic exposure.
The risk climbed with more antibiotic courses and when given earlier in life, particularly within the first six months. The subjects also had a higher likelihood of having a combination of diseases, especially when given multiple prescriptions. Based on varied effects observed according to antibiotic type, the study found cephalosporin antibiotics were tied with the highest risk for multiple diseases, including autism and food allergies.
Previous studies have observed that short-term or low-dose antibiotic therapy can permanently alter the gut microbiome, demonstrating that these commonly prescribed drugs shouldn’t be deemed harmless(ii) but instead should be used with caution, specifically in young children and pregnant women.
A 2019 study had concluded that administering antibiotics in the first year of life and through the subjects’ lifetime was linked to the development of asthma and allergic rhinitis (hay fever).(iii) Prenatal exposure to antibiotics throughout pregnancy was also associated with increased odds of atopic dermatitis within the first 18 months of life among children born by atopic mothers.(iv)
The maternal use of antibiotics during pregnancy was also linked by a separate study to a higher risk of otitis media in their children, emphasizing the possible transmission of an unfriendly bacterial environment from mother to child.(v)
The Gut Microbiome Explained
Mounting evidence reveals that antibiotics influence not just the function of the immune system, but also your ability to fight infections and process food.(vi) It’s therefore critically important to revisit how you use antibiotics.
The gut microbiome begins to form in utero and during birth and is vulnerable to disturbance in the first year of life.(vii) Early disturbances such as antibiotic exposure may adversely affect the gut microbiota by disproportionately changing the bacterial makeup, thus increasing the risk for developing childhood diseases such as allergies.
Bacteria have also developed the ability to defeat certain drugs in the human arsenal that are designed to kill them, heralding the age of antibiotic resistance. According to the U.S. Centers for Disease Control and Prevention (CDC), antibiotic-resistant infections affect at least 2.8 million people in the United States and kill more than 35,000 annually.(viii)
Infections caused by antibiotic-resistant germs are difficult—and sometimes impossible—to treat. In most cases, antibiotic-resistant infections require extended hospital stays, additional follow-up doctor visits, and costly and toxic alternatives.
Study author Martin Blaser, director of the Center for Advanced Biotechnology and Medicine at Rutgers, said the evolution of drug-resistant bacteria illustrated an “unintended” effect of antibiotic overuse.
“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,” he said in a statement.(ix)
The findings provide evidence of the broad and delayed impact of early childhood exposure to antibiotics, encouraging changes in medical practices in prescribing antibiotics—especially for mild conditions, Blaser said. Read more scientific research on antibiotics, along with growing research on antibiotic resistance, on the GreenMedInfo.com database.
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References
(i) Aversa Z et al “Association of Infant Antibiotic Exposure With Childhood Health Outcomes” Mayo Clinic Proceedings, 2020; DOI: 10.1016/j.mayocp.2020.07.019
(ii) Nature Research June 17, 2019 https://www.nature.com/articles/d42859-019-00019-x#:~:text=The%20observation%20that%20the%20gut,children%20and%20pregnant%20women%2C%20and
(iii) Ni J et al “Early antibiotic exposure and development of asthma and allergic rhinitis in childhood” BMC Pediatr. 2019 Jul 5 ;19(1):225. Epub 2019 Jul 5.
(iv) Timm S et al “Prenatal antibiotics and atopic dermatitis among 18-month old children in the Danish National Birth Cohort” Clin Exp Allergy. 2017 Mar 9. Epub 2017 Mar 9.
(v) Pedersen T et al “Antibiotics in Pregnancy Increase Children’s Risk of Otitis Media and Ventilation Tubes” J Pediatr. 2017 Jan 11. Epub 2017 Jan 11.
(vi) Langdon A et al “The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation” Genome Med. 2016 ;8(1):39. Epub 2016 Apr 13.
(vii) Ni J et al “Early antibiotic exposure and development of asthma and allergic rhinitis in childhood” BMC Pediatr. 2019 Jul 5 ;19(1):225. Epub 2019 Jul 5.
(viii) CDC, Antibiotic/Antimicrobial Resistance https://www.cdc.gov/drugresistance/index.html
(ix) Science Daily November 16, 2020 https://www.sciencedaily.com/releases/2020/11/201116075732.htm
