Tip of the Iceberg: Understanding the Unintended Consequences of Antibiotics

Goldman, Jennifer L.; Jackson, Mary Anne

doi:10.1542/peds.2015-1296

Cited by 10 publications

(6 citation statements)

References 11 publications

(11 reference statements)

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“…Our study is consistent with some studies, which showed a similar association between antibiotic exposure in early childhood and an increased risk of obesity. 6,13,15,19,22,25 Scott et al found a similar association to our study, reporting that antibiotic exposure before the age of 2 years increased the odds of childhood obesity at 4 years by 21%, consistent with our study, where antibiotic exposed neonate showed a 37% increase in the risk of obesity at 5 years. An earlier study found the obesity rate among children and adolescents (3-21 years) to be about 47% in the South Bronx.…”

Section: Discussionsupporting

confidence: 92%

“…Association between the gut microbiome composition and the development of these chronic medical conditions has been established in previous research. [11][12][13] In animal models, changes in the microbiome brought about by antibiotics resulted in weight gain through direct effects on growth and metabolic pathways associated with fat production, metabolism, and storage. 14,15 Research in humans has produced mixed results, with some studies showing a significant association between early-life antibiotic exposure and increased risk of development of obesity.…”

mentioning

confidence: 99%

“…Association between the gut microbiome composition and the development of these chronic medical conditions has been established in previous research. 11 12 13…”

mentioning

confidence: 99%

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Neonatal Ampicillin/Gentamicin Exposure and the Risk of Childhood Obesity in South Bronx Pediatric Population

Awujoola,

Torga,

Abdul Ghayum

et al. 2023

Am J Perinatol

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Objective This study aimed to assess the association between neonatal antibiotic exposure and the risk of childhood obesity. Study Design This retrospective cohort study enrolled neonates born between 2011 and 2015 and followed up until 5 years. The incidence of obesity at 5 years old, and other characteristics were compared between the antibiotic-exposed and unexposed groups. Chi-square test was conducted on categorical variables and Student's t-test for normally distributed continuous variable. Significant variables (p < 0.05) in bivariate analysis were modelled in a stepwise multivariate logistic regression analysis to ascertain independent predictors of obesity at 5 years. Results Of the 1,447 subjects, 749 (51.8%) received ampicillin and gentamicin, and 333 (23%) were obese. Neonates exposed to antibiotics were more likely to be obese compared with those unexposed (26 vs. 20%, p = 0.01). In the adjusted model, this association persisted (adjusted odds ratio: 1.37, p = 0.02). Conclusion Neonatal antibiotic exposure is associated with early childhood obesity and may play a significant role in the weight trajectories of these children. Hence, antibiotic stewardship in this period cannot be overemphasized. Key Points

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Section: Discussionsupporting

confidence: 92%

mentioning

confidence: 99%

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Neonatal Ampicillin/Gentamicin Exposure and the Risk of Childhood Obesity in South Bronx Pediatric Population

Awujoola,

Torga,

Abdul Ghayum

et al. 2023

Am J Perinatol

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“…Should the risks that AMR presents to the health of the equine and human populations not be sufficient motivation to restrict and stratify antimicrobial use then there is increasing evidence from the human field of the unintended consequences of the use of antimicrobials on the microbiome and human health . The risk of antimicrobial induced colitis in horses is well known and there is evidence from children of associations between antimicrobial use and intestinal dysbiosis , inflammatory bowel disease , childhood obesity , arthritis , psoriasis and neurodevelopmental disorders .…”

Section: Individual Responsibilitiesmentioning

confidence: 99%

Antimicrobial resistance in companion animals

Rendle¹,

Page

2018

Equine Veterinary Journal

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“…Vedno, ko predpišemo antibiotik, je potrebno pomisliti tudi na morebitne dolgoročne neželene učinke antibiotikov. V zadnjem času je bilo objavljenih več raziskav, ki dokazujejo povezavo med uporabo antibiotikov v zgodnjem otroštvu in različ-nimi avtoimunimi boleznimi (juvenilni revmatoidni artritis, kronična vnetna črevesna bolezen) ter debelostjo, kar lahko predstavlja le vrh ledene gore vseh dolgoročnih neželenih učinkov (30)(31)(32)(33). Selekcijski pritisk antibiotikov na normalno floro in patogene bakterije in po izločanju v okolje je dobro znan, vendar se premalo upošteva pri predpisovanju.…”

Section: Izvirni Znanstveni čLanekunclassified

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

et al. 2017

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Background: Antibiotics are among the most common drugs prescribed in outpatient settings. It is estimated that up to 50 % are prescribed unnecessarily or inappropriately. To plan the actions for optimizing the use of antibiotics, we conducted a national antibiotic consumption study in children aged 0–18 years in the period between 2003 and 2015.Methods: In this national retrospective research we analyzed outpatient antibiotic consumption using ATC/DDD classification. The use of antibiotics was recorded in relation to the pattern of prescription, age, gender and health region.Results: The total consumption of antibiotics decreased by 35 % from 979 to 636 prescriptions per 1000 children/year (PTY) during the whole study period. Te use of all antibiotic classes decreased (except for quinolones and nitrofuran derivatives) by 12.5 %–81 %. In all those years we recorded the highest consumption in children aged 1 to 4 years (2184–1160 PTY). Amoxicillin was the most commonly prescribed antibiotic in children aged 0 to 4 years, penicillin V among 5 to 14 years and co-amoxiclav among adolescents aged 15 to 19 years. In health regions in the northeastern part of Slovenia much more antibiotics were prescribed than in other regions. In 2015, 65 % of prescriptions were prescribed by pediatricians and school medicine specialists, 16 % by physicians without specialization, 14 % by GPs/family doctors and 5 % by other specialists.Conclusions: Despite the decrease in outpatient antibiotic use in children and adolescents in Slovenia, the overall and especially broad-spectrum antibiotic consumption (amoxicillin with clavulanic acid, azithromycin and second/third generation cephalosporins) is still too high. It is necessary to strengthen activities to reduce prescribing, particularly for acute (upper) respiratory tract infections.

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Tip of the Iceberg: Understanding the Unintended Consequences of Antibiotics

Cited by 10 publications

References 11 publications

Neonatal Ampicillin/Gentamicin Exposure and the Risk of Childhood Obesity in South Bronx Pediatric Population

Neonatal Ampicillin/Gentamicin Exposure and the Risk of Childhood Obesity in South Bronx Pediatric Population

Antimicrobial resistance in companion animals

Ambulantna poraba antibiotikov pri otrocih v Sloveniji

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