ArticleThe Journal of infectious diseases2025
Early Childhood Antibiotics and Chronic Pediatric Conditions: A Retrospective Cohort Study.
Article in The Journal of infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Antibiotic Exposure in Early Life and Risk of Type 1 Diabetes: A Meta-Analysis.Diabetes, obesity & metabolism · 2026Pooled it
- The association between early-life (during pregnancy and after birth) antibiotic exposure and type 1 diabetes: an updated meta-analysis.Frontiers in endocrinology · 2026Pooled it
- Association of Early-Life Exposures With Later Diagnosis of Spondyloarthritis: A Population-Based Case-Control Study.The Journal of rheumatology · 2026Article
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- Allergic but not autoimmune comorbidities in children with PFAPA: A nationwide matched case-control cohort study.Pediatric allergy and immunology : official publication of the European Society of Pediatric Allergy and Immunology · 2026Article
- Group B Streptococcus antibiotics treatment during pregnancy and the risk of four neurodevelopmental outcomes in Swedish children.Scientific reports · 2026Article
- Implementation of a pediatric antibiotic stewardship intervention across a large integrated health system: protocol to optimize antibiotic selection and prescription duration for acute respiratory tract infections in children.Implementation science communications · 2026Article
- Development and validation of the childhood allergy comprehensive screening questionnaire and Its application in a cross-sectional survey of allergic diseases among children aged 0-6 Years in Shanghai, China.Frontiers in public health · 2026Article
- Early life antibiotic-use and risk of childhood type 1 diabetes: a nationwide cohort study utilising data linkage.Pediatric diabetes · 2026Article
- The Impact of Antimicrobial Therapy on the Development of Microbiota in Infants.Antibiotics (Basel, Switzerland) · 2025Article
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10 authors.
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Abstract
backgroundEarly childhood antibiotics have been implicated in chronic pediatric conditions, but many studies leave concerns about unmeasured confounding. We evaluated associations between early childhood antibiotics and multiple pediatric conditions.
methodsWe performed a retrospective cohort study using electronic health records data (United Kingdom, 1987-2020). The primary exposure was antibiotic prescriptions between birth and age 2 years. Outcomes were newly diagnosed chronic pediatric conditions (asthma/allergic, autoimmune, neurodevelopmental/psychiatric) or forearm fracture (negative control). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using multivariable Cox regression models adjusted for maternal, child, and area-based socioeconomic covariates. Sibling-matched analyses were conducted using conditional Cox regression.
resultsAmong 1 091 449 children, antibiotic exposure before age 2 was positively associated with asthma (HR, 1.24 [95% CI, 1.22-1.26]), food allergy (HR, 1.33 [95% CI, 1.26-1.40]), and allergic rhinitis (HR, 1.06 [95% CI, 1.03-1.10]), with stronger associations with multiple antibiotic courses. Sibling-matched analyses yielded similar findings. Early childhood antibiotic exposure was also dose-dependently associated with intellectual disability (≥5 vs 1-2 courses: HR, 1.73 [95% CI, 1.49-2.01]; sibling-matched: HR, 2.79 [95% CI, 1.87-4.18]). Consistent associations were not observed for celiac disease, inflammatory bowel disease, juvenile idiopathic arthritis, psoriasis, type 1 diabetes, attention-deficit/hyperactivity disorder, autism spectrum disorders, or anxiety. Sibling-matched results and a negative control outcome suggested minimal confounding.
conclusionsChildren receiving multiple antibiotic courses before age 2 were more likely to develop asthma, food allergies, allergic rhinitis, and intellectual disability. However, antibiotic-associated risks of most autoimmune, neurodevelopmental, and psychiatric conditions studied were minimal.
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