Are we setting up our kids for failure?
New study in JAMA Pediatrics released today associates antibiotic use before age 2 with later childhood obesity. Babies who had received broad-spectrum antibiotics, the kind that kill a wide range of bacteria, were more likely to be obese several years later than babies who had not gotten antibiotics or those who had received narrow-spectrum (targeted) antibiotics. We still cannot say from this paper that antibiotics caused obesity, and we have to be careful to not take too much from this paper. For example, it could also be the case that kids who are sicker tend to also have diets or genetic make-ups that lead to obesity. But...what if broad-spectrum antibiotics did indeed cause obesity? Maybe the antibiotics are changing kids' gut micro biome, or local bacterial environment of the intestines, to kill off "good bacteria" that may protect against obesity. And if this can happen in kids, perhaps in adults too.
Bottom line, as I've often mentioned on this blog and to my patients, we have to be extremely judicious in when and what kind of antibiotics we use. When you have a proven, symptomatic bacterial infection, you absolutely need to use antibiotics and hit them hard. But if you have symptoms similar to infection, such as symptoms that feel like a UTI but without cultures to guide our antibiotics, we have to think twice before throwing antibiotics at the problem.