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Exposure to antibiotics during childhood significantly increases the risk for juvenile idiopathic arthritis in a dose-dependent manner, say investigators reporting at the American College of Rheumatology 2014 Annual Meeting in Boston.
They suggest that alterations in the human microbiome might be implicated in the development of the disease.
“The more we learn about the microbiome, the more it appears that it plays an important role in a variety of different diseases, such as autoimmune diseases — and that includes inflammatory bowel disease and rheumatoid arthritis and perhaps psoriatic arthritis — all of which have some common features with juvenile arthritis,” said Daniel Horton, MD, from the University of Pennsylvania in Philadelphia.
Another Reason to Avoid Antibiotics?
“It’s always good to find another reason not to prescribe antibiotics inappropriately to children, but the fact is that antibiotics can be very useful drugs in certain situations,” Dr Horton said.
Still, the reasons certain children develop arthritis remain poorly understood, he observed, and genetics explains less than half of the cases that do occur.
“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 said.
“We found that antibiotic exposure was associated with an increased risk of developing juvenile arthritis, at an adjusted odds ratio of 2.6, and that the risk increased with each additional prescription,” he told Medscape Medical News.
The nested case–control study “adds to a growing literature on the potential harms of antibiotic use in children,” Dr Horton reported.
Investigators used the Health Improvement Network, a population-based medical records database in the United Kingdom that contains comprehensive diagnostic and outpatient prescription data, to identify people younger than 16 years of age who were newly diagnosed with arthritis.
The 153 children with juvenile arthritis were matched, for age and sex, with 1530 control subjects from general practices in the United Kingdom.
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