Increased risk of allergies and intellectual disability observed in children with early antibiotic exposure: Study

A new study published in The Journal of Infectious Diseases showed that food allergies, asthma, allergic rhinitis, and cognitive impairment were more common in children who had several antibiotic courses before the age of two.

Antibiotics are among the most life-saving medicinal therapies and one of the greatest medical breakthroughs. Their extensive usage, which is occasionally unreasonable or even improper, is a result of their effectiveness and assumed safety. Antibiotics are among the most often prescribed medications for babies and toddlers.

Over two-thirds of infants in certain contexts take antibiotics before they turn two years old, and on average, over half of all children receive at least one antibiotic year, with the largest prevalence occurring during the second year of life. Antibiotics used in early life have also been linked to long-term pediatric illnesses, but numerous research raise questions regarding unmeasured confounding. Thus, this study assessed the relationships between several pediatric diseases and early childhood antibiotics.

This research used data from electronic health records to conduct a retrospective cohort analysis for this study (United Kingdom, 1987–2020). Prescription antibiotics from infancy to age two were the main source of exposure. The results included either a forearm fracture (negative control) or recently identified chronic pediatric illnesses (autoimmune, neurodevelopmental/psychiatric, asthma/allergic).

Asthma, food allergies, and allergic rhinitis were all strongly correlated with antibiotic exposure before age 2 in 1,091,449 children; the correlations were higher for several antibiotic courses. Analyses matched to siblings produced comparable results. Intellectual impairment was likewise dose-dependently linked to early childhood antibiotic exposure.

Celiac disease, inflammatory bowel disease, psoriasis, type 1 diabetes, juvenile idiopathic arthritis, autism spectrum disorders, attention-deficit/hyperactivity disorder, and anxiety did not show consistent relationships. A negative control result and sibling-matched data indicated little confounding.

Overall, between birth and age two, children who get several rounds of antibiotics may be more susceptible to some chronic illnesses. However, the majority of the autoimmune, neurodevelopmental, and psychiatric disorders that were examined had negligible risks related to antibiotics. Although antibiotics are essential for treating bacterial infections, doctors should exercise caution when giving them to children less than two years old since regular usage may have an adverse effect on long-term health.

Source:

Beier, M. A., Setoguchi, S., Gerhard, T., Roy, J., Koffman, D., Mendhe, D., Madej, J., Strom, B. L., Blaser, M. J., & Horton, D. B. (2025). Early childhood antibiotics and chronic pediatric conditions: a retrospective cohort study. The Journal of Infectious Diseases. https://doi.org/10.1093/infdis/jiaf191