Antibiotic treatment in infants: effect on the gastro-intestinal microbiome and long term consequences

  • Linde Peeters Vrije Universiteit Brussel
  • Siel Daelemans Vrije Universiteit Brussel
  • Yvan Vandenplas Vrije Universiteit Brussel
Keywords: antibiotic, immune system, microbiome

Abstract

The gastrointestinal microbiome is crucial for the development of a balanced immune system. Antibiotics are frequently administered to infants and cause intestinal dysbiosis. This narrative review highlights the long term health consequences of antibiotic administration to infants and young children. The necessity of administration of antibiotics should be well considered, since an association with short term consequences such as antibiotic associated diarrhoea and long term adverse effects such as overweight, inflammatory bowel syndrome, allergic disease  have been reported.  Conclusion:  The pros and cons of antibiotic administration to infants and young children should be considered.

Downloads

Download data is not yet available.

Author Biographies

Linde Peeters, Vrije Universiteit Brussel
KidZ Health Castle, UZ Brussel
Siel Daelemans, Vrije Universiteit Brussel
KidZ Health Castle, UZ Brussel
Yvan Vandenplas, Vrije Universiteit Brussel
KidZ Health Castle, UZ Brussel

References

Slykerman RF, Thompson J, Waldie KE, Murphy R, Wall C, Mitchell EA (2017) Antibiotics in the first year of life and subsequent neurocognitive outcomes. Acta Paediatr 106:87-94

Collado MC, Cernada M, Bauerl C, Vento M, Perez-Martinez G (2012) Microbial ecology and host-microbiota interactions during early life stages. Gut Microbes 3:352–365

Yasmin F, Tun HM, Konya TB, Guttman DS, Chari RS, Field CJ, Becker AB, Mandhane PJ, Turvey SE, Subbarao P, Sears MR; CHILD Study Investigators, Scott JA, Dinu I, Kozyrskyj AL (2017) Cesarean section, formula feeding, and infant antibiotic exposure: separate and combined impacts on gut microbial changes in later infancy. Front Pediatr 5:200

Goldenberg JZ, Lytvyn L, Steurich J, Parkin P, Mahant S, Johnston BC (2015) Probiotics for the prevention of pediatric antibiotic-associated diarrhea. Cochrane Database Syst Rev 12:CD004827

Szajewska H, Canani RB, Guarino A, Hojsak I, Indrio F, Kolacek S, Orel R, Shamir R, Vandenplas Y, van Goudoever JB, Weizman Z; ESPGHAN Working Group for Probiotics & Prebiotics (2016) Probiotics for the Prevention of Antibiotic-Associated Diarrhea in Children. J Pediatr Gastroenterol Nutr 62:495-506

Azad MB, Konya T, Persaud RR, Guttman DS, Chari RS, Field CJ, Sears MR, Mandhane PJ, Turvey SE, Subbarao P, Becker AB, Scott JA, Kozyrskyj AL; CHILD Study Investigators (2016) Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. BJOG 123:983-993

Gomez-Arango LF, Barrett HL, McIntyre HD, Callaway LK, Morrison M, Dekker Nitert M (2017) Antibiotic treatment at delivery shapes the initial oral microbiome in neonates. Sci Rep 7:43481

Mazzola G, Murphy K, Ross RP, Di Gioia D, Biavati B, Corvaglia LT, Faldella G, Stanton C (2016) Early gut microbiota perturbations following intrapartum antibiotic prophylaxis to prevent Group B Streptococcal disease. PLoS One 11:e0157527

Aloisio I, Quagliariello A, De Fanti S, Luiselli D, De Filippo C, Albanese D, Corvaglia LT, Faldella G, Di Gioia D (2016) Evaluation of the effects of intrapartum antibiotic prophylaxis on newborn intestinal microbiota using a sequencing approach targeted to multi hypervariable 16S rDNA regions. Appl Microbiol Biotechnol 100:5537-5546

Gonzalez-Perez G, Hicks AL, Tekieli TM, Radens CM, Williams BL, Lamousé-Smith ES (2016) Maternal antibiotic treatment impacts development of the neonatal intestinal microbiome and antiviral immunity. J Immunol 196:3768-3779

Cassidy-Bushrow AE, Burmeister C, Havstad S, Levin AM, Lynch SV, Ownby DR, Rundle AG, Woodcroft KJ, Zoratti EM, Johnson CC, Wegienka G (2017) Prenatal antimicrobial use and early-childhood body mass index. Int J Obes (Lond) Epub ahead of print

Bosch AATM, Piters WAAS, van Houten MA, Chu MLJN, Biesbroek G, Kool J, Pernet P, de Groot PC, Eijkemans MJC, Keijser BJF, Sanders EAM, Bogaert D (2017) Maturation of the Infant Respiratory Microbiota, Environmental Drivers, and Health Consequences. A Prospective Cohort Study. Am J Respir Crit Care Med 196:1582-1590

Forrest CB, Block JP, Bailey LC (2017) Antibiotics, infections, and childhood obesity. Lancet Diabetes Endocrinol 5:2-3

Saari A, Virta LJ, Sankilampi U, Dunkel L, Saxen H (2015) Antibiotic exposure in infancy and risk of being overweight in the first 24 months of life. Pediatrics 135:617-626

Mbakwa CA, Scheres L, Penders J, Mommers M, Thijs C, Arts IC (2016) Early life antibiotic exposure and weight development in children. J Pediatr 176:105-113.e2.

Scott F, Horton DB, Mamtani R, Haynes K, Goldberg DS, Lee DY, Lewis JD (2016) Administration of antibiotics to children before age 2 years increases risk for childhood obesity. Gastroenterology 151:120-129.e5

Azad MB, Bridgman SL, Becker AB, Kozyrskyj AL (2014) Infant antibiotic exposure and the development of childhood overweight and central adiposity.Int J Obes (Lond) 38:1290-1298

Bailey LC, Forrest CB, Zhang P, Richards TM, Livshits A, DeRusso PA (2014) Association of antibiotics in infancy with early childhood obesity. JAMA Pediatr 168:1063-1069

Murphy R, Stewart AW, Braithwaite I, Beasley R, Hancox RJ, Mitchell EA; ISAAC Phase Three Study Group (2014) Antibiotic treatment during infancy and increased body mass index in boys: an international cross-sectional study. Int J Obes (Lond) 38:1115-1119

Korpela K, Zijlmans MA, Kuitunen M, Kukkonen K, Savilahti E, Salonen A, de Weerth C, de Vos WM (2017) Childhood BMI in relation to microbiota in infancy and lifetime antibiotic use. Microbiome 3;5:26

Gerber JS, Bryan M, Ross RK, Daymont C, Parks EP, Localio AR, Grundmeier RW, Stallings VA, Zaoutis TE (2016) Antibiotic exposure during the first 6 months of life and weight gain during childhood. JAMA 315:1258-1265

Hirsch AG, Pollak J, Glass TA, Poulsen MN, Bailey-Davis L, Mowery J, Schwartz BS (2017) Early-life antibiotic use and subsequent diagnosis of food allergy and allergic diseases. Clin Exp Allergy 47:236-244

Metsälä J, Lundqvist A, Virta LJ, Kaila M, Gissler M, Virtanen SM (2013) Mother's and offspring's use of antibiotics and infant allergy to cow's milk. Epidemiology 24:303-309

Metsälä J, Lundqvist A, Virta LJ, Kaila M, Gissler M, Virtanen SM (2015) Prenatal and post-natal exposure to antibiotics and risk of asthma in childhood. Clin Exp Allergy 45:137-145

Risnes KR, Belanger K, Murk W, Bracken MB (2011) Antibiotic exposure by 6 months and asthma and allergy at 6 years: Findings in a cohort of 1,401 US children. Am J Epidemiol 173:310-318

Ong MS, Umetsu DT, Mandl KD (2014) Consequences of antibiotics and infections in infancy: bugs, drugs, and wheezing. Ann Allergy Asthma Immunol 112:441-445.e1.

Pitter G, Ludvigsson JF, Romor P, Zanier L, Zanotti R, Simonato L, Canova C (2016) Antibiotic exposure in the first year of life and later treated asthma, a population based birth cohort study of 143,000 children. Eur J Epidemiol 31:85-94

Murk W, Risnes KR, Bracken MB (2011) Prenatal or early-life exposure to antibiotics and risk of childhood asthma: a systematic review. Pediatrics 127:1125-38

Krajicek EJ, Almazar AE, Larson JJ, Atkinson EJ, Talley NJ, Saito YA (2017) Early Infections and the risk of irritable bowel syndrome: A Case-Control Study. J Clin Gastroenterol [Epub ahead of print]

Uusijärvi A, Bergström A, Simrén M, Ludvigsson JF, Kull I, Wickman M, Alm J, Olén O (2014) Use of antibiotics in infancy and childhood and risk of recurrent abdominal pain--a Swedish birth cohort study. Neurogastroenterol Motil 26:841-850

Oosterloo BC, van Elburg RM, Rutten NB, Bunkers CM, Crijns CE, Meijssen CB, Oudshoorn JH, Rijkers GT, van der Ent CK, Vlieger AM (2018) Wheezing and infantile colic are associated with neonatal antibiotic treatment. Pediatr Allergy Immunol (in press)

Kronman MP, Zaoutis TE, Haynes K, Feng R, Coffin SE (2012). Antibiotic exposure and IBD development among children: a population-based cohort study. Pediatrics 130:e794-803

Hviid A, Svanström H, Frisch M (2011) Antibiotic use and inflammatory bowel diseases in childhood. Gut 60:49-54

Ungaro R, Bernstein CN, Gearry R, Hviid A, Kolho KL, Kronman MP, Shaw S, Van Kruiningen H, Colombel JF, Atreja A (2014) Antibiotics associated with increased risk of new-onset Crohn's disease but not ulcerative colitis: a meta-analysis. Am J Gastroenterol 109:1728-1738

Boursi B, Mamtani R, Haynes K, Yang YX (2015) The effect of past antibiotic exposure on diabetes risk. Eur J Endocrinol 172:639-648

Mikkelsen KH, Knop FK, Frost M, Hallas J, Pottegård A (2015) Use of antibiotics and risk of type 2 diabetes: a population-based case-control study. J Clin Endocrinol Metab 100:3633-3640

Mikkelsen KH, Knop FK, Vilsbøll T, Frost M, Hallas J, Pottegård A (2017) Use of antibiotics in childhood and risk of Type 1 diabetes: a population-based case-control study. Diabet Med 34:272-277

Ilić K, Jakovljević E, Skodrić-Trifunović V (2012) Social-economic factors and irrational antibiotic use as reasons for antibiotic resistance of bacteria causing common childhood infections in primary healthcare. Eur J Pediatr 171:767-777

Alm B, Erdes L, Möllborg P, Pettersson R, Norvenius SG, Aberg N, Wennergren G (2008) Neonatal antibiotic treatment is a risk factor for early wheezing. Pediatrics 121:697-702

Metsälä J, Lundqvist A, Virta LJ, Kaila M, Gissler M, Virtanen SM (2015) Prenatal and post-natal exposure to antibiotics and risk of asthma in childhood. Clin Exp Allergy 45:137-145

Metsälä J, Lundqvist A, Virta LJ, Kaila M, Gissler M, Virtanen SM [2013] Mother's and offspring's use of antibiotics and infant allergy to cow's milk. Epidemiology 24:303-309

Murk W, Risnes KR, Bracken MB [2011] Prenatal or early-life exposure to antibiotics and risk of childhood asthma: a systematic review. Pediatrics 127:1125-1138

Pedersen TM, Stokholm J, Thorsen J, Mora-Jensen AC, Bisgaard H (2017) Antibiotics in pregnancy increase children's risk of otitis media and ventilation tubes. J Pediatr 183:153-158.e1

Submitted

2018-07-21
Accepted
2018-07-21
Published
2018-08-23
Section
Articles