Antibiotic exposure was associated with newly diagnosed juvenile idiopathic arthritis, according to results published by Dr. Daniel B. Horton and coauthors from the department of pediatrics at Rutgers Robert Wood Johnson Medical School, New Brunswick, N.J.

In a case-control study that compared children who had newly diagnosed juvenile idiopathic arthritis (JIA) with controls matched by age and gender, antibiotic exposure was associated with an increased rate of JIA (adjusted odds ratio, 2.1; 95% confidence interval, 1.2-3.5). The relationship was strongest within 1 year of diagnosis, and was dose dependent, with an increased magnitude of association with more antibiotic courses (P < .001), Dr. Horton and his colleagues reported.

The findings suggest “a potential role for antibiotics in the pathogenesis of JIA, perhaps mediated through changes in the microbiome,” the authors said. “If this association is causal, antibiotics could be considered a potentially modifiable risk factor for JIA, especially in light of the overprescribing of antibiotics to children, particularly for respiratory tract infections.”

Additionally, children with JIA “may also be at risk for more infections before diagnosis due to immune dysfunction, and a causal role for infections remains a possibility,” the authors concluded.

The full study was published online July 20 in Pediatrics ( doi:10.1542/peds.2015-0036 ).


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