Childhood infection, antibiotic exposure and subsequent metabolic risk in adolescent and young adult Aboriginal Australians: practical implications.

There is now evidence linking antibiotic burden in infancy and subsequent risk factors for cardiometabolic disease. In this study we assessed the metabolic health of a community-based cohort of Aboriginal Australians aged 15-25 years and retrospectively examined their early childhood antibiotic burden to identify a possible link between the two. Metabolic health data were extracted from electronic files of 433 participants in prior Young Persons Checks between 2013 and 2016. More than one-third were overweight or obese. Males had more metabolic syndrome than females (20.6% vs 10%; P=0.03). Metabolic syndrome was twice as common in the 20- to 25-year age group than in the 15- to 19-year age group (19.8% vs 9.7%; P<0.001). A subsequent medical chart review focused on childhood infections and the antibiotic burden of participants in the Young Persons Check from birth to 15 years of age. Nearly 75% were prescribed antibiotics during their first 2 years of life and 29% were exposed four or more times. Childhood antibiotic burden decreased with age. This population of Aboriginal adolescents and young adults has high rates of antibiotic exposure in childhood and metabolic abnormalities. We did not find a correlation between the two within the cohort, potentially demonstrating a ceiling effect.