Antibiotic Exposures and the Likelihood of Developing Pediatric Autoimmune Diseases: a Register-based Matched Case-control Study [post]

Laura Räisänen, Sohvi Kääriäinen, Reijo Sund, Elina Engberg, Heli Viljakainen, Kaija-Leena Kolho
2021 unpublished
Incidences of pediatric autoimmune diseases (ADs) have been increasing without clearly identified environmental risk factors. Using national registers (special reimbursement and drug purchase register), this matched case-control study aims to discover whether antibiotic exposures are related to development of ADs in general. From a cohort of 11,407 children (born 2000-2005, followed-up until December 2018), 242 children with ADs (type 1 diabetes (DM), autoimmune thyroiditis (AIT), juvenile
more » ... athic arthritis (JIA), and inflammatory bowel diseases (IBD)) generated the case group. Each case was matched with one to four child(ren) with similar age, sex, residential area, gestational age, and delivery mode, generating 708 matched controls. Number of antibiotic purchases throughout childhood was unrelated to the development of the studied ADs as one group, nor with DM, AIT, or IBD individually. While antibiotic exposures in infancy did not increase the likelihood of ADs, exposures to macrolides within two years before diagnosis showed minor association (OR 1.24, 95% CI 1.01-1.51). Exposures to cephalosporins, macrolides, and amoxicillin-clavulanic acid throughout childhood may increase the likelihood of JIA (OR 1.25, 95% CI 1.03-1.52; OR 1.21, 95% CI 1.06-1.38; OR 1.19, 95% CI 1.02-1.39, respectively). Regardless of frequent use in childhood (40% of all antibiotics), penicillins were not associated with the onset of any ADs.Conclusion: Occasional use of antibiotics are relatively safe regarding overall development of ADs. Penicillins are unlikely to be associated with any ADs, while broad-spectrum antibiotics (including macrolides) should be used considerately as they may associate with an increased likelihood of ADs, especially JIA.
doi:10.21203/rs.3.rs-1110501/v1 fatcat:azasmjh5g5epvmar5vunkjwcpe