{"doi":"10.1093/infdis/jiaf191","title":"Early Childhood Antibiotics and Chronic Pediatric Conditions: A Retrospective Cohort Study","abstract":"BACKGROUND: Early childhood antibiotics have been implicated in chronic pediatric conditions, but many studies leave concerns about unmeasured confounding. We evaluated associations between early childhood antibiotics and multiple pediatric conditions. METHODS: We performed a retrospective cohort study using electronic health records data (United Kingdom, 1987-2020). The primary exposure was antibiotic prescriptions between birth and age 2 years. Outcomes were newly diagnosed chronic pediatric conditions (asthma/allergic, autoimmune, neurodevelopmental/psychiatric) or forearm fracture (negative control). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using multivariable Cox regression models adjusted for maternal, child, and area-based socioeconomic covariates. Sibling-matched analyses were conducted using conditional Cox regression. RESULTS: Among 1 091 449 children, antibiotic exposure before age 2 was positively associated with asthma (HR, 1.24 [95% CI, 1.22-1.26]), food allergy (HR, 1.33 [95% CI, 1.26-1.40]), and allergic rhinitis (HR, 1.06 [95% CI, 1.03-1.10]), with stronger associations with multiple antibiotic courses. Sibling-matched analyses yielded similar findings. Early childhood antibiotic exposure was also dose-dependently associated with intellectual disability (≥5 vs 1-2 courses: HR, 1.73 [95% CI, 1.49-2.01]; sibling-matched: HR, 2.79 [95% CI, 1.87-4.18]). Consistent associations were not observed for celiac disease, inflammatory bowel disease, juvenile idiopathic arthritis, psoriasis, type 1 diabetes, attention-deficit/hyperactivity disorder, autism spectrum disorders, or anxiety. Sibling-matched results and a negative control outcome suggested minimal confounding. CONCLUSIONS: Children receiving multiple antibiotic courses before age 2 were more likely to develop asthma, food allergies, allergic rhinitis, and intellectual disability. However, antibiotic-associated risks of most autoimmune, neurodevelopmental, and psychiatric conditions studied were minimal.","journal":"The Journal of Infectious Diseases","year":2025,"id":513295,"datarank":0.3596842909197557,"base_score":2.3978952727983707,"endowment":2.3978952727983707,"self_citation_contribution":0.3596842909197557,"citation_network_contribution":0.0,"self_endowment_contribution":0.3596842909197557,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":10,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.716,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":281090,"name":"Soko Setoguchi","orcid":"0000-0002-1583-752X","position":1,"is_corresponding":false},{"id":504255,"name":"Tobias Gerhard","orcid":"0000-0002-8598-5771","position":2,"is_corresponding":false},{"id":247078,"name":"Jason Roy","orcid":"0000-0001-5178-4210","position":3,"is_corresponding":false},{"id":1374975,"name":"Dawn Koffman","orcid":null,"position":4,"is_corresponding":false},{"id":1204073,"name":"Dinesh Mendhe","orcid":"0000-0003-1158-3259","position":5,"is_corresponding":false},{"id":248117,"name":"Joanna Madej","orcid":null,"position":6,"is_corresponding":false},{"id":382875,"name":"Brian L. Strom","orcid":"0000-0001-5750-4232","position":7,"is_corresponding":false},{"id":19777,"name":"Martin J. Blaser","orcid":"0000-0003-2447-2443","position":8,"is_corresponding":false},{"id":247077,"name":"Daniel B. Horton","orcid":"0000-0002-1831-1339","position":9,"is_corresponding":false},{"id":1374329,"name":"Matthew A. Beier","orcid":"0000-0002-4680-2821","position":0,"is_corresponding":true}],"reference_count":35,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-19T02:48:17.908238Z","pmid":"40237450","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}