Rochester, MN—Antibiotics given to infants and young toddlers appear to be linked to several immunological, metabolic, and neurobehavioral childhood-onset health conditions, even after adjusting for several established infant and maternal confounders, according to a new study.

“Our findings are consistent with the hypothesis that the early-life microbiome composition is a critical health determinant and that perturbations during key developmental periods can have long-term consequences,” write Mayo Clinic authors.

Results of the retrospective case study, published in Mayo Clinic Proceedings, caution about administering antibiotics to children younger than age 2 years. To reach those conclusions, researchers used health-record data from the Rochester Epidemiology Project, a population-based research collaboration in Minnesota and Wisconsin, analyzing data from more than 14,500 children. About 70% of the children had received at least one treatment with antibiotics for illness before age 2 years, and the study team found that children receiving multiple antibiotic treatments were more likely to have multiple illnesses or conditions later in childhood.

The study notes that early life host-microbiome interactions contribute to the proper development of the immune system and that antibiotics significantly alter microbial composition, adding that “even transient perturbations during critical developmental periods may compromise both immune tolerance and inflammatory responses.”

The report advises that types and frequency of illness varied depending on age, type of medication, dose and number of doses, as well as gender. The authors write that conditions associated with early use of antibiotics included:
• Asthma
• Allergic rhinitis
• Weight issues and obesity
• Food allergies
• Attention-deficit hyperactivity disorder
• Celiac disease
• Atopic dermatitis

Researchers posit that, while antibiotics might only transiently affect the microbiome, long-term health consequences can result.

“We want to emphasize that this study shows association—not causation—of these conditions,” explained senior author Nathan LeBrasseur, PhD, a researcher at Mayo Clinic’s Robert and Arlene Kogod Center on Aging. “These findings offer the opportunity to target future research to determine more reliable and safer approaches to timing, dosing and types of antibiotics for children in this age group.”

The study sought to determine how much antibiotic exposure in the first 2 years of life is associated with the risk of immunological, metabolic, and neurobehavioral health conditions with childhood onset. It determined that hazard ratios for the conditions above ranged from 1.20 to 2.89; P <.05 for all.

“Moreover, children exposed to antibiotics had a higher probability of having combinations of conditions, particularly when given multiple prescriptions,” the authors write.

“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,” the researchers conclude.

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