TOPLINE: 

A retrospective cohort study showed that exposure to antibiotics, particularly narrow-spectrum agents, during the first 2 years of life is associated with a dose-dependent increase in the odds of overweight and obesity from childhood through late adolescence.

METHODOLOGY:

• Early antibiotic use can disrupt the infant gut microbiota by reducing diversity, depleting beneficial taxa, and altering metabolite profiles.
• Researchers conducted a retrospective cohort study using real-world data to examine whether antibiotic exposure in infancy was associated with the development of overweight or obesity in childhood and adolescence.
• They compared 65,280 infants (52.2% male) exposed to antibiotics in the first 2 years of life with 11,560 unexposed infants (46.1% male).
• Antibiotics were classified as narrow-spectrum (amoxicillin and penicillin) or broad-spectrum (all other agents).
• The study outcome was obesity or overweight, evaluated across four age groups: young children (2 to < 6 years), children (6 to < 12 years), early adolescents (12 to < 16 years), and late adolescents (16 to < 19 years). 

TAKEAWAY:

• Infants exposed to antibiotics had significantly higher adjusted mean BMI percentiles than unexposed peers in childhood (57.83 vs 55.02), early adolescence (58.20 vs 55.11), and late adolescence (57.42 vs 55.04; P < .001 for all).
• Early antibiotic exposure was associated with 27% higher odds of overweight or obesity during late adolescence (P < .001).
• A dose-response relationship was observed for narrow-spectrum antibiotics, with the odds ratio for overweight and obesity in late adolescence rising from 1.15 for one to two packs to 1.52 for more than 10 packs. Similar associations were observed for childhood and early adolescence.

IN PRACTICE:

“Understanding the changes in gut microbiota equilibrium due to use of antibiotics during infancy could lead to the development of personalized therapies to restore the balance in the gut microenvironment,” the authors wrote. “Such therapies could be useful as an adjunctive treatment in the management of overweight and obesity.”

SOURCE:

The study was led by Eilon Heyman, School of Public Health, Gray Faculty of Medical & Health Sciences, Tel Aviv University, Tel Aviv, Israel. It was published online in the International Journal of Obesity.

LIMITATIONS: 

Unmeasured factors such as diet, breastfeeding, physical activity, and parental obesity may have influenced the observed associations. Actual medication consumption could not be verified, and antibiotics prescribed outside the Maccabi Healthcare Services network were not recorded.

DISCLOSURES:

The study reported no funding source, and the authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.