Antibiotics prior to age 2 years have limited association with preschool growth trajectory.
Journal
International journal of obesity (2005)
ISSN: 1476-5497
Titre abrégé: Int J Obes (Lond)
Pays: England
ID NLM: 101256108
Informations de publication
Date de publication:
04 2022
04 2022
Historique:
received:
06
02
2020
accepted:
05
11
2021
revised:
20
07
2021
pubmed:
10
1
2022
medline:
5
4
2022
entrez:
9
1
2022
Statut:
ppublish
Résumé
Prior studies of early antibiotic use and growth have shown mixed results, primarily on cross-sectional outcomes. This study examined the effect of oral antibiotics before age 24 months on growth trajectory at age 2-5 years. We captured oral antibiotic prescriptions and anthropometrics from electronic health records through PCORnet, for children with ≥1 height and weight at 0-12 months of age, ≥1 at 12-30 months, and ≥2 between 25 and 72 months. Prescriptions were grouped into episodes by time and by antimicrobial spectrum. Longitudinal rate regression was used to assess differences in growth rate from 25 to 72 months of age. Models were adjusted for sex, race/ethnicity, steroid use, diagnosed asthma, complex chronic conditions, and infections. 430,376 children from 29 health U.S. systems were included, with 58% receiving antibiotics before 24 months. Exposure to any antibiotic was associated with an average 0.7% (95% CI 0.5, 0.9, p < 0.0001) greater rate of weight gain, corresponding to 0.05 kg additional weight. The estimated effect was slightly greater for narrow-spectrum (0.8% [0.6, 1.1]) than broad-spectrum (0.6% [0.3, 0.8], p < 0.0001) drugs. There was a small dose response relationship between the number of antibiotic episodes and weight gain. Oral antibiotic use prior to 24 months of age was associated with very small changes in average growth rate at ages 2-5 years. The small effect size is unlikely to affect individual prescribing decisions, though it may reflect a biologic effect that can combine with others.
Sections du résumé
BACKGROUND
Prior studies of early antibiotic use and growth have shown mixed results, primarily on cross-sectional outcomes. This study examined the effect of oral antibiotics before age 24 months on growth trajectory at age 2-5 years.
METHODS
We captured oral antibiotic prescriptions and anthropometrics from electronic health records through PCORnet, for children with ≥1 height and weight at 0-12 months of age, ≥1 at 12-30 months, and ≥2 between 25 and 72 months. Prescriptions were grouped into episodes by time and by antimicrobial spectrum. Longitudinal rate regression was used to assess differences in growth rate from 25 to 72 months of age. Models were adjusted for sex, race/ethnicity, steroid use, diagnosed asthma, complex chronic conditions, and infections.
RESULTS
430,376 children from 29 health U.S. systems were included, with 58% receiving antibiotics before 24 months. Exposure to any antibiotic was associated with an average 0.7% (95% CI 0.5, 0.9, p < 0.0001) greater rate of weight gain, corresponding to 0.05 kg additional weight. The estimated effect was slightly greater for narrow-spectrum (0.8% [0.6, 1.1]) than broad-spectrum (0.6% [0.3, 0.8], p < 0.0001) drugs. There was a small dose response relationship between the number of antibiotic episodes and weight gain.
CONCLUSION
Oral antibiotic use prior to 24 months of age was associated with very small changes in average growth rate at ages 2-5 years. The small effect size is unlikely to affect individual prescribing decisions, though it may reflect a biologic effect that can combine with others.
Identifiants
pubmed: 34999718
doi: 10.1038/s41366-021-01023-w
pii: 10.1038/s41366-021-01023-w
pmc: PMC8967797
mid: NIHMS1754545
doi:
Substances chimiques
Anti-Bacterial Agents
0
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
843-850Subventions
Organisme : Patient-Centered Outcomes Research Institute
ID : OBS-1505-30699
Pays : United States
Investigateurs
Brad Appelhans
(B)
David Arterburn
(D)
Andrew Brickman
(A)
Matthew F Daley
(MF)
Arthur Davidson
(A)
Elizabeth Dawson-Hahn
(E)
Amanda Dempsey
(A)
Lara R Dugas
(LR)
Jonathan Finkelstein
(J)
Stephanie L Fitzpatrick
(SL)
Matthew J Gurka
(MJ)
Andrea Goodman
(A)
William J Heerman
(WJ)
Michael Horberg
(M)
Md Jobayer Hossain
(MJ)
Daniel S Hsia
(DS)
Jenny Ingber
(J)
Carmen R Isasi
(CR)
Melanie Jay
(M)
Elyse Kharbanda
(E)
Peter Margolis
(P)
M James
(M)
Mary Jo Messito
(MJ)
Kathleen Murphy
(K)
Kevin O'Bryan
(K)
Holly Peay
(H)
Micah T Prochaska
(MT)
Jon Puro
(J)
Goutham Rao
(G)
Maria Rayas
(M)
Marc Rosenman
(M)
H Robert
(H)
Bradley Taylor
(B)
Alfredo Tirado-Ramos
(A)
Jeffrey VanWormer
(J)
Zachary Willis
(Z)
Samrat Yeramaneni
(S)
Informations de copyright
© 2022. The Author(s), under exclusive licence to Springer Nature Limited.
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