In the Journals

Antibiotics during infancy may lead to early childhood obesity

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September 29, 2014

Infants exposed to broad-spectrum antibiotics before age 24 months were more likely to experience early childhood obesity, according to recently published data.

L. Charles Bailey, MD, PhD, of the pediatrics department at The Children’s Hospital of Philadelphia, and colleagues examined the electronic health records of 64,580 children from 2001 to 2013. Participants were eligible if they had annual visits from 0 to 23 months, as well as at least one follow-up by age 5 years.

Charles L. Bailey, MD, PhD

L. Charles Bailey

For all children, the prevalence of obesity was 10% at 2 years, 14% at 3 years and 15% at 4 years. The prevalence of overweight or obese was 23%, 30% and 33% at the same ages.

Children received a mean of 2.3 antibiotic treatment episodes from 0 to 23 months. Sixty-nine percent of children had at least one exposure to antibiotics during this time, with 62% exposed to narrow-spectrum antibiotics (penicillin and amoxicillin) and 41% to broad-spectrum antibiotics.

Researchers observed increased risk with greater antibiotic use when examining all antibiotics, as well as broad-spectrum drugs alone, with the risk increasing after cumulative exposure. No significant association was seen between obesity and narrow-spectrum antibiotics.

Several other previously identified associations with obesity risk factors were also present. Male sex, public insurance, Hispanic ethnicity, steroid use, diagnosed asthma and an urban practice environment were each associated with childhood obesity within the study group.

“Because obesity is a multifactorial condition, reducing prevalence depends on identifying and managing multiple risk factors whose individual effects may be small but modifiable,” the researchers wrote. “Our results suggest that the use of broad-spectrum outpatient antibiotics before age 24 months may be one such factor. This provides additional support for the adoption of treatment guidelines for common pediatric conditions that emphasize limiting antibiotic use to cases where efficacy is well demonstrated and preferring narrow-spectrum drugs in the absence of specific indications for broader coverage.” — by Dave Muoio

Disclosure: Funding was provided by an unrestricted donation from the American Beverage Foundation for a Healthy America to The Children’s Hospital of Philadelphia to support the Healthy Weight Program.

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