Antibiotics in early life and obesity

Cox, Laura M.; Blaser, Martin J.

doi:10.1038/nrendo.2014.210

Cited by 471 publications

(349 citation statements)

References 82 publications

(106 reference statements)

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“…12,33,34 The effects of some medications on the development of obesity have received considerable attention, for example, the effect of antibiotic use during childhood on obesity 35 Use of other drugs is also related to weight gain and obesity, including several classes of antidepressants: SSRIs, SNRIs and TCAs. 36 These antidepressants are also associated with gut microbiota alterations, which could potentially be a mechanisms by which these drugs cause weight gain.…”

Section: Bmi and Lipid Metabolismmentioning

confidence: 99%

The influence of proton pump inhibitors and other commonly used medication on the gut microbiota

et al. 2017

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Proton pump inhibitors (PPIs), used to treat gastro-esophageal reflux and prevent gastric ulcers, are among the most widely used drugs in the world. The use of PPIs is associated with an increased risk of enteric infections. Since the gut microbiota can, depending on composition, increase or decrease the risk of enteric infections, we investigated the effect of PPI-use on the gut microbiota. We discovered profound differences in the gut microbiota of PPI users: 20% of their bacterial taxa were statistically significantly altered compared with those of non-users. Moreover, we found that it is not only PPIs, but also antibiotics, antidepressants, statins and other commonly used medication were associated with distinct gut microbiota signatures. As a consequence, commonly used medications could affect how the gut microbiota resist enteric infections, promote or ameliorate gut inflammation, or change the host's metabolism. More studies are clearly needed to understand the role of commonly used medication in altering the gut microbiota as well as the subsequent health consequences.KEYWORDS gut microbiota; medication; proton pump inhibitors Proton pump inhibitors affect the gut microbiotaProton pump inhibitors (PPIs), used to treat gastroesophageal reflux and to prevent gastric ulcers, are among the most commonly used drugs in the world.1,2 In the Netherlands, one PPI alone (omeprazole) was the fourth most prescribed drug in 2015. In observational studies, the use of PPIs has been associated with an increased risk of enteric infections caused by Clostridium difficile, Salmonella spp., Shigella spp and Campylobacter spp. [3][4][5] Since the gut microbiota can, depending on composition, increase or decrease the risk of enteric infections, we investigated the effect of PPI use on the gut microbiota. 6 Using the 16S rRNA sequences of stool samples from 1815 individuals spanning 3 independent cohorts, we observed profound changes in the gut microbiota of PPI users. In PPI users the relative abundance of 20% of the bacterial taxa, whereof 18 bacterial families, was statistically significantly different (either increased or decreased) compared with abundances in samples from non-users. 6 Concurrently with our research, other research groups were also investigating the influence of PPIs on the gut microbiota. A small intervention study was published a few months before ours and a similar observational study was published in the same issue of Gut. 7,8 In Table 1, the bacterial alterations associated with PPI use from all 3 studies are presented at the family level. There are many similarities between the results of all 3 studies and, when associations at different taxonomical levels are taken into account (e.g. the decrease of order Clostridiales and increases of class Gammaproteobacteria and order Actinomycetales), a consistent profile of alterations in gut microbiota associated with PPI use emerges. Other commonly used drugs and the gut microbiotaTo ensure that our observed alterations in gut microbiota associated wi...

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Section: Bmi and Lipid Metabolismmentioning

confidence: 99%

The influence of proton pump inhibitors and other commonly used medication on the gut microbiota

et al. 2017

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“…There have been a number of documented incidences in which pharmaceutical companies have not been forthcoming with safety information (Lurie and Wolfe 2005). In recent years, long-term antibiotic use, particularly in the young, has been shown to have adverse health outcomes (Cox and Blaser 2015), yet no pharmaceutical company has faced regulatory consequences. The presence of antibiotics and a range of other drugs in drinking water is now widely reported (Cox and Blaser 2015;Khan et al 2016), presumably owing to urinary excretion.…”

Section: Issues Within the Current Regulatory Frameworkmentioning

confidence: 99%

A suggestion for evolution of Canada’s health regulatory system

White

Reid

2018

FACETS

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Aspects of Canada's health regulatory system are currently being reviewed. This is timely, as the regulation and definition of drugs, foods, and natural health products (NHPs) is in need of revision to facilitate greater transparency and less ambiguity. A number of studies have illustrated the importance of a nutritious diet to prevent and manage chronic disease. Therefore, legislation surrounding food health claims needs to be adjusted so that it is more informative for disease prevention and, in some cases, treatment. Canada is modernizing the regulation of self-care products, under which NHPs, including probiotic products, are listed. With the growing appreciation for the role that microbes play in human health and the recognition that many foods, including those containing probiotic organisms, can prevent or mitigate disease, this provides an opportunity to reassess regulatory categories.

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“…In one study, it was found that elimination of Lactobacillus, Allobaculum, Rikenelleceae, and Candidatus arthromitus led to metabolic changes in rats that eventually welcomed the onset of obesity [56]. To further highlight the impact the composition of an individual's intestinal flora can have on the tendency to gain weight, it was discovered that when germ free mice were given fecal transplants from an Broad-Spectrum Antibiotic Abuse and its Connection to Obesity.…”

Section: Gut Composition Differs Between Obese and Lean Individualsmentioning

confidence: 99%

Broad-Spectrum Antibiotic Abuse and its Connection to Obesity

Czaja¹

2017

JNHFS

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The purpose of this review was to assess patterns of antibiotic prescriptions across the United States and evaluate their relationship with associated conditions. A focus on national antibiotic prescriptions and proposed side effects was studied from 1993-2008. State-to-state differences in antibiotic prescribing and associated patterns of obesity were studied from 2011-2014. Data for these study periods was extracted from the CDC and affiliated institutions. Correlation assessments between antibiotic prescription patterns and a set of variables related to the proposed mechanism of antibiotic effects were made. From 2011-2014, cephalosporin prescriptions demonstrated the strongest relationship with associated obesity rates, while beta-lactams (cephalosporins and penicillins) showed weaker relationships when taken as a holistic class. To make light of these results, drug use of Ceftriaxone, a broad-spectrum, third-generation cephalosporin and Amoxicillin, a narrow-spectrum penicillin, was compared from 1993 to 2008 in relation to the prevalence of various health conditions: obesity; diabetes mellitus; sleep disorders; endocrine, nutritional, metabolic diseases and immunity disorders; and infectious and parasitic diseases. Ceftriaxone demonstrated a strong, significant, and positive relationship with all of the above variables, except for parasitic and infectious diseases. By comparison, Amoxicillin showed weak and non-significant relationships with all of the above variables. Despite their correlational limitations, these results suggest that broad-spectrum antibiotics play a significant role in the development and persistence of many chronic conditions in the United States. A mechanism providing a hypothesized explanation for these results was proposed based on extensive literature review.

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Antibiotics in early life and obesity

Cited by 471 publications

References 82 publications

The influence of proton pump inhibitors and other commonly used medication on the gut microbiota

The influence of proton pump inhibitors and other commonly used medication on the gut microbiota

A suggestion for evolution of Canada’s health regulatory system

Broad-Spectrum Antibiotic Abuse and its Connection to Obesity

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