Early antibiotic use not linked with celiac or T1 diabetes autoantibodies

Last Updated: 2017-10-10

By Anne Harding

NEW YORK (Reuters Health) - Early-life antibiotic use does not appear to increase at-risk children's likelihood of developing celiac disease or type 1 diabetes, findings from the TEDDY study show.

"The standard antibiotics used in pediatric practice have no effect on causing autoimmune disease," Dr. Eric Triplett of the University of Florida in Gainesville told Reuters Health in a telephone interview.

Evidence of a potential association between early antibiotic treatment and autoimmunity has been mixed, Dr. Triplett and his team note in their October 9 JAMA Pediatrics online report.

Many of the studies that have found an association were done in mice. "Oddly enough, the antibiotics used in the rodent studies are almost never the ones used in children," Dr. Triplett noted.

He and his colleagues looked at data from The Environmental Determinants of Diabetes in the Young (TEDDY) study, taken from six centers in four countries.

The new analysis included 8,495 children tested for islet autoantibodies and 6,558 tested for tissue transglutaminase autoantibodies. All carried one of the nine HLA genotypes associated with type 1 diabetes, some of which also have been linked to celiac disease.

Amoxicillins accounted for about 42% of antibiotic use in children ages 3 months to 4 years, while other compounds accounted for less than 9% each. There was no association between treatment with amoxicillins, beta-lactam antibiotics, or macrolides and the risk of developing autoantibodies to islet cells or tissue transglutaminase.

"There may be some rarely used antibiotics that have an effect on type 1 diabetes, but we couldn't see it," Dr. Triplett said. If such an effect was present, he added, "they're so rarely used they aren't likely at all to be playing a role in the ever-increasing incidence of type 1 diabetes over time."

He and his colleagues may revisit this question in older children, but he indicated that clinicians treating children who may be at risk for celiac disease or type 1 diabetes should not be afraid to use standard childhood antibiotics when indicated.

SOURCE: http://bit.ly/2gpD5xi

JAMA Pediatr 2017.