Juvenile arthritis risk may be increased by antibiotics says analysis of large UK database
Taking antibiotics could increase the risk that a child will develop juvenile arthritis, according to a study published in Pediatrics.
Previous studies have suggested that antibiotics could predispose children to develop some chronic diseases, such as inflammatory bowel disease. Disruption of bacterial communities in the intestines and elsewhere appears to play a role in inflammatory bowel disease and other autoimmune diseases, including rheumatoid arthritis in adults.
So using a database with information on over 11 million people from the UK, the researchers compared children with newly diagnosed juvenile arthritis with age- and gender-matched control subjects. Of the 450,000 children studied, 152 were diagnosed with juvenile arthritis. After adjusting for other autoimmune conditions and previous infection, children who received prescriptions for antibiotics had twice the risk of developing juvenile arthritis. The more courses of antibiotics prescribed, the higher the risk.
Upper respiratory tract infections treated with antibiotics seemed to be more strongly associated with juvenile arthritis than untreated upper respiratory tract infections. Antiviral and antifungal drugs were not linked to juvenile arthritis, suggesting that risk for arthritis was specific to antibacterial medicines.
About a quarter of antibiotics prescribed to children (and half of antibiotics prescribed for acute respiratory infections) are thought to be unnecessary.
“This is an extremely important clue about the etiology of this serious and potentially crippling disease,” says lead author, Brian Strom. “If confirmed, it also provides a means for preventing it.”
Daniel Horton is also involved in the work and comments:
“An alternative explanation to our findings is that an abnormal immune system makes children more susceptible to serious infection even before they are diagnosed with arthritis. Under this hypothesis, antibiotics would be a marker for abnormal immunity rather than a direct cause of arthritis. A majority of children get antibiotics, but only about 1 in 1,000 get arthritis. So even if antibiotics do contribute to the development of arthritis, it’s clearly not the only factor.”
So more research needs to confirm the findings and to understand the mechanisms that might link antibiotic use and arthritis in children.
Click here to read the original research.
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Image credit: Sascha Kohlmann
