Taking a combination of medicines, including antibiotics and acid suppressants, during the first two years of life was associated with a diagnosis of obesity in children, according to research published in Gut.
Christopher M. Stark, MD, of the department of pediatrics at William Beaumont Army Medical Center in El Paso, Texas, and colleagues wrote that these medications have an effect on the gut microbiota that could ultimately result in weight gain in children.
“Many commonly prescribed medications have microbiota-altering effects via selectively promoting or inhibiting the growth of specific bacterial species,” they wrote. “Gastric acid secretion-inhibiting medications and antibiotics can affect the gut microbiota by acting directly in a bacterial or bacteriostatic manner. Medication-induced gut microbiota alterations may persist indefinitely.”
Researchers used a cohort of United States Department of Defense TRICARE beneficiaries born between October 2006 and September 2013 (n = 333,353) to assess any association between antibiotic, histamine-2-receptor antagonist and proton pump inhibitor prescriptions during early childhood and a diagnosis of obesity. Investigators found that 241,502 children were prescribed an antibiotic (72.4%), 39,488 were prescribed an H2RA (11.8%) and 11,089 were prescribed a PPI (3.3%).
Stark and colleagues determined that antibiotics were associated with obesity (HR = 1.26; 95% CI, 1.23-1.28), and the link persisted regardless of antibiotic class. Additionally, the association grew stronger with each additional class of antibiotic prescribed.
Prescriptions for H2RAs or PPIs were also associated with obesity, and the link was stronger with each 30-day supply prescribed.
Stark and colleagues wrote that while antibiotics and antacids have an important role, physicians should be careful not to overprescribe, especially among younger children.
“Medication overprescription and overmedicalization of physiological symptoms persists, despite growing evidence of negative health consequences, especially related to alterations of the human microbiome,” they wrote. “Although there is mounting evidence of unanticipated consequences associated with antibiotic and antacid medication use, providers should practice appropriate stewardship as the first-line response to these findings.” – by Alex Young
Disclosures: The authors report no relevant financial disclosures.