March 30, 2016
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Childhood obesity risk increases with antibiotic use under age 2 years

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The administration of three or more courses of antibiotics in children younger than 2 years was found to be associated with an increased risk for childhood obesity, according to a retrospective cohort study.

“Our work supports the theory that antibiotics may progressively alter the composition and function of the gut microbiome, thereby predisposing children to obesity as is seen in livestock and animal models,” Frank Irving Scott, MD, MSCE, assistant professor of medicine at University of Colorado Anschutz Medical Campus, Aurora, and adjunct scholar, Center for Clinical Epidemiology and Biostatistics at University of Pennsylvania, said in a press release.

Scott and colleagues conducted a population-based, retrospective cohort study involving 21,714 children in the United Kingdom to examine obesity at age 4 years and a possible link to the use of antibiotics when the children were younger than 2 years. They performed logistic regression analyses using data from electronic medical records in the Health Improvement Network from 1995 to 2013.

The primary outcome was obesity at age 4.

Researchers assessed antibiotic exposure in children registered into the database by age 3 months, with complete height and weight available within 12 months of their fourth birthday.

The researchers adjusted for obesity in the mother and siblings, the mother’s diabetes status, mode of delivery, socioeconomic status, year and country of birth, as well as urban living.

Of the children analyzed, 6.4% (n = 1,306) were obese at age 4 years, and a significant association was found between early childhood obesity and the administration of three of more antibiotic prescriptions in children younger than 2 years (OR = 1.21; 95% CI, 1.07-1.38). As the number of antibiotics prescribed went up, the risk increased: for one to two prescriptions the OR was 1.07 (95% CI, 0.91-.23); for three to five prescriptions, the OR was 1.41 (95% CI, 1.2-1.65); and for six or more prescriptions, the OR was 1.47 (95% CI, 1.19-1.82).

Moreover, the researchers found no association between obesity and antifungal agents.

“Our results do not imply that antibiotics should not be used when necessary, but rather encourage both physicians and parents to think twice about antibiotic usage in infants in the absence of well-established indications,” Scott said in the press release. – by Suzanne Reist

Disclosures: Scott reports he has received research support, unrelated to this research, from Takeda. No authors report they have received support from any company directly related to this study. Please see the full study for a list of all other researchers’ relevant financial disclosures.