Childhood Antibiotic Use Not Linked to Islet or Celiac Disease Autoimmunity

Microscopic image of langerhans.
Microscopic image of langerhans.
Islet and celiac disease autoimmunity were defined as a positive test result for islet or tissue transglutaminase autoantibodies at 2 clinic visits at least 3 months apart.

Early childhood antibiotic use does not increase a person’s risk of developing islet or celiac disease autoimmunity, according to research published in JAMA Pediatrics.

Eric W. Triplett, PhD, of the Department of microbiology and Cell Science at the Institute of Food and Agricultural Sciences at the University of Florida in Gainesville, and colleagues analyzed data from the prospective birth cohort of The Environmental Determinants of Diabetes in the Young (TEDDY) study ( Identifier NCT00279318).

Participants included TEDDY enrollees (test results were positive in 8495 and 6558 children for islet and tissue transglutaminase autoantibodies, respectively) with 38,152 recorded instances of antibiotic use over the first 2 years of life. Amoxicillin compounds accounted for 42.3% of all reported uses, and were most commonly prescribed for otitis media (62% of all instances of antibiotic prescriptions). β-lactam and macrolide antibiotics accounted for 70.5% of all uses in 48 months of life.

In total, 5.5% of participants developed islet autoantibodies before 49.5 months; median age at seroconversion was 21.4 months (range: 12.2-33.0 mo). Median age of seroconversion to multiple islet autoantibodies was 24.3 months (range: 16.5-33.4 mo). Cumulative, first-, and second-year exposure was not associated with development of islet autoantibodies.

Celiac disease autoimmunity was identified in 11.9% of patients before 49.5 months. Median age at seroconversion was 30.6 months (range: 23.7-37.9 mo); cumulative, 6-month, first-, and second-year antibiotic exposure was not associated with celiac disease autoimmunity.

“The use of most prescribed antibiotics during the first 4 years of life…was not associated with the development of autoimmunity for [type 1 diabetes] or [celiac disease],” Dr Trippett and colleagues concluded. “These results suggest that a risk of islet or tissue transglutaminase autoimmunity need not influence the recommendations for clinical use of antibiotics in young children at risk for [type 1 diabetes] or [celiac disease].”

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Kemppainen KM, Vehik K, Lynch KF, et al; for Environmental Determinants of Diabetes in the Young (TEDDY) Study Group. Association between early-life antibiotic use and the risk of islet or celiac disease autoimmunity [published online October 9, 2017]. JAMA Pediatr. doi:10.1001/jamapediatrics.2017.2905