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Antibiotic Exposure Before Age 2 May Increase Risk for Chronic Pediatric Conditions

Risk seen for asthma, food allergies, allergic rhinitis, and intellectual disability

By Lori Solomon HealthDay Reporter

WEDNESDAY, April 30, 2025 (HealthDay News) — Children receiving multiple antibiotic courses between birth and age 2 years may have a higher risk for some chronic conditions, according to a study published online April 16 in the Journal of Infectious Diseases.

Matthew A. Beier, M.D., from the Rutgers Robert Wood Johnson Medical School in Piscataway, New Jersey, and colleagues evaluated associations between early-childhood antibiotic exposure (between birth and age 2 years) and allergic, autoimmune, or neurodevelopmental/psychiatric conditions. The analysis included electronic health record data from roughly 1.1 million children in the United Kingdom (1987 to 2020).

The researchers found that early antibiotic exposure was positively associated with asthma (hazard ratio [HR], 1.24), food allergy (HR, 1.33), and allergic rhinitis (HR, 1.06). Stronger associations were seen following multiple antibiotic courses. Similar findings were seen from sibling-matched analyses. There was a dose-dependent association between early-childhood antibiotic exposure and intellectual disability (five or more versus one to two courses: HR, 1.73; sibling-matched: HR, 2.79). No significant associations were seen for celiac disease, inflammatory bowel disease, juvenile idiopathic arthritis, psoriasis, type 1 diabetes, attention-deficit/hyperactivity disorder, autism spectrum disorders, or anxiety.

“Antibiotics play a critical role in combating bacterial infections, but physicians should be judicious when prescribing antibiotics to children under 2, as frequent use may affect long-term health outcomes,” coauthor Daniel B. Horton, M.D., from Rutgers University in New Brunswick, New Jersey, said in a statement.

Several authors disclosed ties to relevant organizations.

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