Antibiotic and acid-suppression medications during early childhood are associated with obesity
Abstract
Objective: Gut microbiota alterations are associated with obesity. Early exposure to medications, including acid suppressants and antibiotics, can alter gut biota and may increase the likelihood of developing obesity. We investigated the association of antibiotic, histamine-2 receptor antagonist (H2RA) and proton pump inhibitor (PPI) prescriptions during early childhood with a diagnosis of obesity. Design: We performed a cohort study of US Department of Defense TRICARE beneficiaries born from October 2006 to September 2013. Exposures were defined as having any dispensed prescription for antibiotic, H2RA or PPI medications in the first 2 years of life. A single event analysis of obesity was performed using Cox proportional hazards regression. Results: 333 353 children met inclusion criteria, with 241 502 (72.4%) children prescribed an antibiotic, 39 488 (11.8%) an H2RA and 11 089 (3.3%) a PPI. Antibiotic prescriptions were associated with obesity (HR 1.26; 95% CI 1.23 to 1.28). This association persisted regardless of antibiotic class and strengthened with each additional class of antibiotic prescribed. H2RA and PPI prescriptions were also associated with obesity, with a stronger association for each 30-day supply prescribed. The HR increased commensurately with exposure to each additional medication group prescribed. Conclusions: Antibiotics, acid suppressants and the combination of multiple medications in the first 2 years of life are associated with a diagnosis of childhood obesity. Microbiota-altering medications administered in early childhood may influence weight gain.
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A large cohort study of 333,353 children in the United States reported that prescriptions of antibiotics and acid-suppressive medications in the first two years of life are associated with obesity later in childhood; these associations were strengthened with each additional class of these microbiota-altering drugs and with each additional 30-day prescription.
“A large cohort study of 333,353 children in the United States reported that prescriptions of antibiotics and acid-suppressive medications in the first two years of life are associated with obesity later in childhood; these associations were strengthened with each additional class of these microbiota-altering drugs and with each additional 30-day prescription.131”
From Emerging issues in probiotic safety: 2023 perspectives (2023) · cites this paper as [131]
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Emerging issues in probiotic safety: 2023 perspectives
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- Authors
- Stark, C. M., Susi, A., Emerick, J., & Nylund, C. M.
- Affiliations
- William Beaumont Army Medical Center (US)
- Uniformed Services University of the Health Sciences (US)
- Corresponding author
- Stark, Christopher M
- Venue
- Gut
- Publisher
- BMJ
- Published
- 2018-10-30
- Volume
- 68
- Issue
- 1
- Pages
- 62-69
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- OpenAlex
- W2899382281
- Cited by
- 115
- References
- 7
- Citations by year
- 2026: 6 · 2025: 9 · 2024: 13 · 2023: 15 · 2022: 16 · 2021: 13 · 2020: 26 · 2019: 15 · 2018: 2
- FWCI
- 4.99
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Gut (publishedVersion)
- PubMed (publishedVersion)
- HighWire Press Open Archive (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Medicine › Pharmacology › Pharmacology and Obesity Treatment
- Keywords
- childhood obesity, antibiotic exposure, proton pump inhibitors, H2 receptor antagonists, gut microbiota
- MeSH terms
- Gastrointestinal Microbiome, Anti-Bacterial Agents, Child, Child, Preschool, Female, Histamine H2 Antagonists, Humans, Infant, Male, Obesity, Retrospective Studies, Risk Factors, United States, Proton Pump Inhibitors
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