Antibiotic use predisposes children to obesity and asthma.

Antibiotics are the most commonly used drugs in children in western countries and early-life antibiotic use is associated with increased risk for inflammatory bowel disease(1) obesity(2,3,4) and asthma(5).

Mouse studies indicate the microbiome dysbiosis (unhealthy gut bacteria) plays a causal role. However, little is known about the impacts of antibiotics on the developing microbiome of children.

In a paper published this week in the journal Nature Communications the research group of Willem M. de Vos show that antibiotic use in childhood is associated with significant changes in the intestinal microbiome composition, which persist for over 6 months.

The group observed differences in the microbiome composition of antibiotic-treated children when compared with those who were not exposed to antibiotics for more than 2 years. The macrolide family of antibiotics (the best known member being erythromycin) were the main offenders. Penicillin family antibiotics however, had less pronounced effects.

Thus, the study confirms in human what has been seen in mouse studies previously. Childhood use of erythromycin-like antibiotics (macrolides) predisposes children to obesity and asthma.

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1. Virta, L., Auvinen, A., Helenius, H., Huovinen, P. & Kolho, K. Association of repeated exposure to antibiotics with the development of pediatric Crohn's disease-a nationwide, register-based Finnish Case-Control Study. Am. J. Epidemiol. 175, 775–784 (2012).

2. Trasande, L. et al. Infant antibiotic exposures and early-life body mass. Int. J. Obes. 37, 16–23 (2013).

3. Bailey, L. C. et al. Association of antibiotics in infancy with early childhood obesity. JAMA Pediatr. 168, 1063–1069 (2014).

4. Saari, A., Virta, L. J., Sankilampi, U., Dunkel, L. & Saxen, H. Antibiotic exposure in infancy and risk of being overweight in the first 24 months of life. Pediatrics 135, 617–626 (2015).

5. Penders, J., Kummeling, I. & Thijs, C. Infant antibiotic use and wheeze and asthma risk: a systematic review and meta-analysis. Eur. Resp. J. 38, 295–302 (2011).

6. Korpela et al., (2016) Intestinal microbiome is related to lifetime antibiotic use in Finnish pre-school children. Nat. Comm. 7, Article number: 10410 doi:10.1038/ncomms10410.