Early Life Antibiotic Exposure Linked to Juvenile Idiopathic Arthritis

Exposure to antibiotics early in life is associated with late onset of juvenile idiopathic arthritis, according to data published in Pediatric rheumatology.

“Antibiotics are one of the most common prescription drugs in children and they appear to interfere with the normal maturation of the microbiome.” Erik Kindgren, MARYLAND, from Skaraborg Hospital in Skövde, Sweden, and colleagues wrote. “A recent systematic review compiled evidence that antibiotic exposure in children is associated with a reduction in richness and / or diversity and a change in the species balance in the microbiome with reductions in number of commensal bacteria considered beneficial. “

“The use of antibiotics has been shown to be associated with both JIA and RA,” they added. “However, [whether] the association is due to an increased number of infections, rather than the use of the antibiotic, is unknown.

To analyze the link between antibiotic use, as well as infections, and JIA, Kindgren and colleagues looked at data from the All Babies Southeast Sweden (ABIS) cohort. According to the researchers, ABIS has so far enrolled 17,055 families of children born in south-eastern Sweden from October 1, 1997 to October 1, 1999. Blood samples from the children were taken at birth and then at 1. , 3, 5 and 8 years. Meanwhile, parental questionnaires collected data on nutrition, infections, drug use, vaccinations and other factors at the same intervals.

For their own study, Kindgren and colleagues identified a total of 102 children with JIA. They performed multivariate logistic regression analyzes, adjusting for confounding factors, to examine the association between infections, antibiotics, and later-onset JIA.

According to the researchers, the use of antibiotics for 1 to 12 months, 1 to 3 years and 5 to 8 years was significantly associated with an increased risk of JIA.

In addition, the risk of developing JIA was three times higher in children exposed to antibiotics in their first 3 years of life, compared to children who had not received antibiotics (aOR = 3.17; 95% CI: 1.11-9.03). The risks of JIA were more than twice as high in people exposed to antibiotics in the first 5 years of life, compared to those not exposed (aOR = 2.18; 95% CI: 1.36-3 , 5). Among people exposed to antibiotics in the first 8 years of life, the odds of JIA were 78% higher than those not exposed (aOR = 1.78; 95% CI: 1.15-2.73).

Meanwhile, infection during fetal life or childhood demonstrated no significant association with the risk of JIA after adjustment for confounding factor.

“This study shows that antibiotic exposure early in life is associated with later onset of JIA in a large birth cohort of the general population,” Kindgren and colleagues wrote. “The relationship was dose-dependent. Infection per se during childhood showed no significant association with the risk of developing JIA after adjusting for confounding factors. The results suggest a causal relationship between the use of antibiotics in particular and the development of JIA. Regardless of the mediating mechanisms, these results suggest that restrictive antibiotic policies in the first years of life should be recommended. “