Antibiotic Exposure Does Not Lead to Obesity: True or False?

Summary and Comment |
March 22, 2016

Antibiotic Exposure Does Not Lead to Obesity: True or False?

  1. Louis M. Bell, MD

Antibiotic exposure during the first 6 months of life was not associated with weight gain during the first 8 years in this well-done, large, retrospective study.

  1. Louis M. Bell, MD

Studies in mice show that exposure to antibiotics affects the gut microbiome, alters metabolism, and results in increased adiposity. In addition, observational studies have suggested an association between antibiotic exposure and obesity in children. To assess the association between early antibiotic exposure and weight gain during a child's first 8 years of life, researchers reviewed records of children born between 2001 and 2011 (≥35 weeks gestation; weight ≥2000 g) in a network of 30 mid-Atlantic pediatric practices.

Of 38,522 children, 14% were exposed to antibiotics in the first 6 months of life (mean age, 4.3 months) and 67% were exposed by 24 months (52% received broad-spectrum antibiotics, 19% macrolides). In regression analysis, exposure to any antibiotic in the first 6 months was not associated with the rate of change in weight. In subanalyses, number of antibiotic courses and antibiotic type also were not associated with weight trajectory. Exposure to any antibiotic in the first 24 months of life was associated with a 2.1% increase in the rate of weight gain, equivalent to an increase of 150 g between ages 2 and 5 years.

In a matched analysis of 46 twin pairs, there was no difference in weight change between twins exposed and those not exposed to antibiotics in the first 6 months or 24 months.

Comment

This study calls into question the previously reported link between antibiotic use and obesity in children. As the authors note, there are many reasons why we should be judicious in our use of antibiotics in children, but risk for obesity may not be one of them.

Editor Disclosures at Time of Publication

  • Disclosures for Louis M. Bell, MD at time of publication Grant / Research support NIH Institutional Clinical and Translational Science Award; AHRQ National Center for Pediatric Practice Based Research Learning; Patient-Centered Outcomes Research Institute Editorial boards Current Problems in Pediatric Adolescent Healthcare, Associate Editor

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