Researchers say children exposed to antibacterial antibiotics may be at increased risk of juvenile idiopathic arthritis.
Juvenile idiopathic arthritis (JIA), also called juvenile rheumatoid arthritis (JRA), is a condition that usually occurs in children before the age of 16. It is characterized by inflammation of the joints, which can cause pain, swelling and stiffness. JIA can also cause rash, fever and eye inflammation.
It is estimated that around 300,000 children in the US have some form of arthritis, with JIA being the most common.
JIA is an autoimmune disease, meaning it develops when the immune system attacks the body's own cells and tissues. However, the reasons behind this are unclear.
"Previous studies have shown that genetics explains less than half of cases of JIA," notes lead study author Dr. Daniel Horton of Nemours Alfred I. duPont Hospital for Children in Wilmington, DE. "Other studies have not consistently identified any one particular environmental trigger."
Past research, however, has indicated that the body's microbiome - an array of microorganisms that regulate metabolic and immune function - may play a role in the development of autoimmune diseases, such as rheumatoid arthritis and inflammatory bowel disease (IBD). Furthermore, previous studies have suggested that early antibiotic use in children may be linked to IBD development.
With this in mind, Dr. Horton and his team wanted to see whether antibiotic use in children may influence onset of JIA.
JIA risk strongest in children exposed to multiple courses of antibiotics
Using data from a UK population-based database of medical records - The Health Improvement Network - the team identified 153 children who had been diagnosed with JIA before the age of 16.
They also randomly selected age- and sex-matched children without JIA to act as controls, and the antibiotic exposure of all children was assessed.
The researchers found that children exposed to antibacterial antibiotics - not antifungals or antivirals - were at higher risk of developing JIA than those who had not been exposed to these antibiotics. This risk was higher for children who had been exposed to multiple courses of antibiotics.
These findings remained even after accounting for the children's age at antibiotic exposure and other confounding factors, the researchers say.
According to Dr. Horton, the team's results add to a growing number of studies documenting the harms of antibiotic use in children. He adds:
"While antibiotics are certainly essential to treating some infections, these drugs are also overprescribed for other infections - frequently respiratory - that will usually resolve without treatment.
If the link between antibiotics and juvenile arthritis can be confirmed, antibiotic avoidance - in the right clinical situation - might be one of the few ways we have to prevent this life-changing disease."
Dr. Horton notes, however, that much more is to be learned about the biology that links antibiotic use in children to JIA. "Additional research in this area may also lead to novel ways of preventing and treating juvenile arthritis, similar to what is emerging now for IBD," he adds.
In September, Medical News Today reported on a study published in the journal Pediatrics suggesting that each year, doctors write 11.4 million unnecessary antibiotic prescriptions for children and teenagers.