Antibiotics, Pediatric Dysbiosis, and Disease

Abstract

Antibiotics are by far the most common medications prescribed for children. Recent epidemiological data suggests an association between early antibiotic use and disease phenotypes in adulthood. Antibiotic use during infancy induces imbalances in gut microbiota, called dysbiosis. The gut microbiome’s responses to antibiotics and its potential link to disease development are especially complex to study in the changing infant gut. Here, we synthesize current knowledge linking antibiotics, dysbiosis, and disease and propose a framework for studying antibiotic-related dysbiosis in children. We recommend future studies into the microbiome-mediated effects of antibiotics focused on four types of dysbiosis: loss of keystone taxa, loss of diversity, shifts in metabolic capacity, and blooms of pathogens. Establishment of a large and diverse baseline cohort to define healthy infant microbiome development is essential to advancing diagnosis, interpretation, and eventual treatment of pediatric dysbiosis. This approach will also help provide evidence-based recommendations for antibiotic usage in infancy.

Antibiotic perturbation of the preterm infant gut microbiome and resistome

“…Decreased species richness in infancy has been associated with a number of host pathologies. 13,25,40,41 To identify factors that significantly contribute to species richness, Gibson et al developed a generalized linear mixed model with individual included as a random effect, leveraging available metadata including infant health (e.g. CRIB II (Clinical Risk Index for Babies) score, day of life, gestational age, birthweight, delivery mode, and presence of positive culture), medications (e.g., antibiotics, caffeine, and iron), and maternal health (e.g.…”

“…3,[6][7][8] Perturbation of the gut microbiota during this key developmental window can have lasting effects on host physiology and disease risk. [9][10][11][12][13][14] One of the most common perturbations during this period, antibiotic therapy, 13,15 can substantially alter the gut microbiota and infant physiology. 10,[16][17][18][19][20][21] Because preterm infants are at high risk for infection, antibiotics are the most commonly prescribed medications in neonatal intensive care units (NICUs) in the United States ( Fig.…”

Human Gut Microbiota and Obesity During Development

“…Besides short-term-efects, the dysbiosis produced by antibiotics administration in infants may produce long-term efects like the persistence of the risk of obesity development. It has been observed that 3 months after of antibiotics persists the microbiota disruption [120]. However, antibiotic administration to neonates has been linked to several critical clinical conditions in which modiication of the microbiota composition is thought to play a relevant role, in diseases such as necrotizing enterocolitis and sepsis [121,122].…”

Impact of Early-Life Microbiota on the Development of Infants

“…Нарушения становления микробиоты на ранних этапах онтогенеза могут способствовать в дальнейшем развитию атопии, бронхиальной астмы, ожирения. В настоящее время широко обсуждается роль микробиоты кишечника в пато-генезе аутизма [36].…”