{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:11:13Z","timestamp":1789657873978,"version":"4.0.1"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:00:00Z","timestamp":1744761600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K23AR070286"],"award-info":[{"award-number":["K23AR070286"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01AR074436"],"award-info":[{"award-number":["R01AR074436"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR003017"],"award-info":[{"award-number":["UL1TR003017"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UM1TR004789"],"award-info":[{"award-number":["UM1TR004789"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["U01AI22285"],"award-info":[{"award-number":["U01AI22285"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","award":["R01HD109335"],"award-info":[{"award-number":["R01HD109335"]}],"id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["UG3OD035527"],"award-info":[{"award-number":["UG3OD035527"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008217","name":"Emch Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008217","id-type":"DOI","asserted-by":"publisher"}]},{"name":"and Sergei Zlinkoff Foundation"},{"name":"C & D Fund"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Early childhood antibiotics have been implicated in chronic pediatric conditions, but many studies leave concerns about unmeasured confounding. We evaluated associations between early childhood antibiotics and multiple pediatric conditions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We performed a retrospective cohort study using electronic health records data (United Kingdom, 1987\u20132020). The primary exposure was antibiotic prescriptions between birth and age 2 years. Outcomes were newly diagnosed chronic pediatric conditions (asthma\/allergic, autoimmune, neurodevelopmental\/psychiatric) or forearm fracture (negative control). Hazard ratios (HRs) with 95% confidence intervals (CIs) were estimated using multivariable Cox regression models adjusted for maternal, child, and area-based socioeconomic covariates. Sibling-matched analyses were conducted using conditional Cox regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1 091 449 children, antibiotic exposure before age 2 was positively associated with asthma (HR, 1.24 [95% CI, 1.22\u20131.26]), food allergy (HR, 1.33 [95% CI, 1.26\u20131.40]), and allergic rhinitis (HR, 1.06 [95% CI, 1.03\u20131.10]), with stronger associations with multiple antibiotic courses. Sibling-matched analyses yielded similar findings. Early childhood antibiotic exposure was also dose-dependently associated with intellectual disability (\u22655 vs 1\u20132 courses: HR, 1.73 [95% CI, 1.49\u20132.01]; sibling-matched: HR, 2.79 [95% CI, 1.87\u20134.18]). Consistent associations were not observed for celiac disease, inflammatory bowel disease, juvenile idiopathic arthritis, psoriasis, type 1 diabetes, attention-deficit\/hyperactivity disorder, autism spectrum disorders, or anxiety. Sibling-matched results and a negative control outcome suggested minimal confounding.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Children receiving multiple antibiotic courses before age 2 were more likely to develop asthma, food allergies, allergic rhinitis, and intellectual disability. However, antibiotic-associated risks of most autoimmune, neurodevelopmental, and psychiatric conditions studied were minimal.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/infdis\/jiaf191","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T09:02:01Z","timestamp":1744794121000},"page":"659-668","source":"Crossref","is-referenced-by-count":15,"title":["Early Childhood Antibiotics and Chronic Pediatric Conditions: A Retrospective Cohort Study"],"prefix":"10.1093","volume":"232","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4680-2821","authenticated-orcid":false,"given":"Matthew A","family":"Beier","sequence":"first","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School , Piscataway, New Jersey ,","place":["USA"]},{"name":"Department of Surgery, New York University Medical Center , New York, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soko","family":"Setoguchi","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health , Piscataway, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tobias","family":"Gerhard","sequence":"additional","affiliation":[{"name":"Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health , Piscataway, New Jersey ,","place":["USA"]},{"name":"Department of Pharmacy Practice and Administration, Ernest Mario School of Pharmacy, Rutgers University , Piscataway, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5178-4210","authenticated-orcid":false,"given":"Jason","family":"Roy","sequence":"additional","affiliation":[{"name":"Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Department of Biostatistics and Epidemiology, Rutgers School of Public Health , Piscataway, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn","family":"Koffman","sequence":"additional","affiliation":[{"name":"Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-3259","authenticated-orcid":false,"given":"Dinesh","family":"Mendhe","sequence":"additional","affiliation":[{"name":"Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Madej","sequence":"additional","affiliation":[{"name":"Rutgers Robert Wood Johnson Medical School , Piscataway, New Jersey ,","place":["USA"]},{"name":"Department of Anesthesiology, Stanford University School of Medicine , Stanford, California ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5750-4232","authenticated-orcid":false,"given":"Brian L","family":"Strom","sequence":"additional","affiliation":[{"name":"Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Rutgers Biomedical and Health Sciences , Newark, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin J","family":"Blaser","sequence":"additional","affiliation":[{"name":"Department of Medicine, Rutgers Robert Wood Johnson Medical School , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Center for Advanced Biotechnology and Medicine, Rutgers University , Piscataway, New Jersey ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1831-1339","authenticated-orcid":false,"given":"Daniel B","family":"Horton","sequence":"additional","affiliation":[{"name":"Rutgers Center for Pharmacoepidemiology and Treatment Science, Institute for Health, Health Care Policy and Aging Research , New Brunswick, New Jersey ,","place":["USA"]},{"name":"Department of Biostatistics and Epidemiology, Rutgers 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