Early Exposure to Antibiotics tied with Juvenile Idiopathic Arthritis: Study

The aetiology of juvenile idiopathic arthritis (JIA) is poorly understood. It has been shown that the use of antibiotics is associated with JIA. However, whether the association is due to the increased occurrence of infection in these individuals is unknown.

Two researchers from Sweden conducted a study to measure the association between the number of infections and the use of antibiotics during childhood with the development of JIA.

In ABIS (All Babies in Southeast Sweden) a population-based prospective birth cohort of 17,055 children, data were collected on infections and antibiotic exposure during pregnancy and childhood. 102 individuals with JIA were identified. Multivariable logistic regression analyses were performed, adjusting for confounding factors.

The results of the study are as follows:

· Exposure to antibiotics during the periods 1-12 months, 1-3 years and 5-8 years was significantly associated with increased risk for JIA.

· The odds of developing JIA were three times higher in those exposed to antibiotics during the first 3 years of life compared with those not exposed, and more than twice as high in those exposed to antibiotics during the first 5 years of life compared with those not exposed.

· The odds of developing JIA were 78% higher in those exposed to antibiotics during the first 8 years of life compared with those not exposed.

· Occurrence of infection during fetal life or childhood showed no significant association with the risk of developing JIA, after confounder adjustment. The cumulative number of courses of antibiotics was significantly higher during childhood for the individuals who developed JIA.

· Penicillins were more frequently used than non-penicillins, but both had an equal effect on the risk of developing JIA.

Thus, the researchers concluded that exposure to antibiotics early in life is associated with the later onset of JIA in a large birth cohort from the general population. The relationship was dose-dependent. These results suggest that further, more restrictive, antibiotic policies during the first years of life would be advisable.

Reference:

Infections and antibiotics during fetal life and childhood and their relationship to juvenile idiopathic arthritis: a prospective cohort study by Erik Kindgren and Johnny Ludvigsson published in the Pediatric Rheumatology.

doi: 10.1186/s12969-021-00611-4.