Prescribing Antibiotics to Infants Increases Childhood Obesity Risk

Clinicians should be diligent when prescribing antibiotics to young children, as the use of antibiotics before age 2 has been linked to an increased risk of early childhood obesity.

A recent study published online inGastroenterologyexamined the relationship between antibiotic exposures before 2 years of age and obesity at 4 years of age in a large group of British children.

The researchers found that children who were treated with antibiotics in infancy had a 25% higher risk of developing obesity by age 4 than those who were not given antibiotics. This association was particularly strong in children who received 3 or more antibiotic courses.

“Antibiotics have been used to promote weight gain in livestock for several decades, and our research confirms that antibiotics have the same effect in humans,” said study author Frank Irving Scott, MD, MSCE, in a press release. “Our results do not imply that antibiotics should not be used when necessary, but rather encourage both physicians and parents to think twice about antibiotic usage in infants in the absence of well-established indications.”

The study authors noted that further research is required to determine whether this association between antibiotics and obesity persists into adolescence and young adulthood, as well as to assess whether specific antibiotics are more strongly linked to obesity than others.

Despite the increased risk ofantibiotic resistanceand other complications, more than 10 million antibiotic prescriptions are written for children without a clear indication each year, according to the study authors. Retail clinicians can play a role in reducing unnecessary antibiotic prescribing, as arecent surveypublished inJAMA Pediatricsrevealed that many parents prefer bringing their children to a retail clinic over a pediatrician.

When treating infants with upper respiratory tract infections, for instance, retail clinicians can follow recommendations on appropriate antibiotic prescribing that wererecently establishedby the American College of Physicians (ACP) and the US Centers for Disease Control and Prevention (CDC). The organizations’ suggest not starting a patient with bronchitis on antibiotic therapy unless pneumonia is suspected, and never prescribing antibiotics to patients with the common cold.

“Although it is everyone's responsibility to use antibiotics appropriately, providers have the power to control prescriptions,” the ACP and CDC wrote. “Reducing inappropriate antibiotic prescribing will improve quality of care, decrease health care costs, and preserve the effectiveness of antibiotics.”

Clinicians are also ideally placed to help manage childhood obesity.

One way to do so is to educate parents on appropriate weight norms for children. According to astudypublished inChildhood Obesity, 95% of parents with overweight children believed their child’s weight was “just about the right weight,” indicating that many parents have trouble recognizing when their kids have reached an unhealthy weight.

Additionally, clinicians caninstructparents to serve their children more fruits and vegetables, as well as foods rich in potassium, magnesium, calcium, and fiber, and to encourage their children to partake in at least 1 hour of physical activity each day.