Neonatal Ampicillin/Gentamicin Exposure and the Risk of Childhood Obesity in South Bronx Pediatric Population

Abstract

Objective This study aimed to assess the association between neonatal antibiotic exposure and the risk of childhood obesity. Study Design This retrospective cohort study enrolled neonates born between 2011 and 2015 and followed up until 5 years. The incidence of obesity at 5 years old, and other characteristics were compared between the antibiotic-exposed and unexposed groups. Chi-square test was conducted on categorical variables and Student's t-test for normally distributed continuous variable. Significant variables (p < 0.05) in bivariate analysis were modelled in a stepwise multivariate logistic regression analysis to ascertain independent predictors of obesity at 5 years. Results Of the 1,447 subjects, 749 (51.8%) received ampicillin and gentamicin, and 333 (23%) were obese. Neonates exposed to antibiotics were more likely to be obese compared with those unexposed (26 vs. 20%, p = 0.01). In the adjusted model, this association persisted (adjusted odds ratio: 1.37, p = 0.02). Conclusion Neonatal antibiotic exposure is associated with early childhood obesity and may play a significant role in the weight trajectories of these children. Hence, antibiotic stewardship in this period cannot be overemphasized. Key Points

Pharmacokinetic and Pharmacodynamic Considerations of Antibiotic Use in Neonates

“…The optimal choice of antibiotic treatment (regimen and duration) is an important element in order to reduce antibiotic misuse and overuse among neonates, which are associated with adverse effects, including antibiotic resistance, increased risk of invasive candidiasis, necrotizing enterocolitis, viral and bacterial superinfections, death, and longterm effects, like early childhood obesity and chronic diseases later in life [69][70][71][72][73][74][75][76][77].…”