By Ariana Eunjung Cha
When a parent carrying a screaming toddler with a middle-ear infection or other common ailment shows up, many pediatricians instinctively reach for their prescription pads. Despite warnings about the risk of resistance, antibiotics remain one of the most frequently used weapons in routine care. But now doctors have another reason to be cautious: the risk of obesity.
In a study published online Sept. 30 by JAMA Pediatrics, researchers reviewed records from about 65,000 children from 2001 to 2013 and found that almost 70 percent received antibiotics before age 2. On average, each child received 2.3 courses.
Those who received only a few courses of less powerful antibiotics did not appear to have a higher risk of obesity than those who received none.
But those who were treated with repeated courses — four or more — during that period were 11 percent more likely to become obese. The effect of repeated use of more powerful, broad-spectrum antibiotics appeared to be even stronger: Children who got those more powerful antibiotics were 16 percent more likely than those who got none to become obese.
Those exposed to broad-spectrum antibiotics early in life, at 0 to 5 months of age, had an 11 percent greater risk of becoming obese.
The researcher team, led by L. Charles Bailey at the Children’s Hospital of Philadelphia, recommended that pediatricians should consider narrowing their use of broad-spectrum antibiotics.
The use of antibiotics in routine care is one of the most contentious issues in pediatric medicine. In recent years, many physician groups, including the American Academy of Pediatrics, have launched efforts to reduce the use of antibiotics. A study published in February in the journal Pediatrics suggested that the downward trend in antibiotic use in children may have plateaued, suggesting that further efforts to reduce prescriptions are necessary.