Antibiotic Use Could Cause Arthritis in Children

Did you know that about 73% of antibiotics are inappropriately prescribed every year? This means that nearly 3 of every 4 antibiotics dispensed were prescribed inappropriately.

What's worse, a new study from the Center for Clinical Epidemiology and Biostatistics at the University of Pennsylvania indicates that children who receive inappropriately prescribed antibiotics have a higher risk for juvenile idiopathic arthritis (JIA).

JIA is the development of arthritis in children before sexual maturity. It shows typical arthritic symptoms, often morning stiffness or arthralgia during the day, spiking fevers once or twice each day at about the same time, and evanescent rash on the trunk and extremities.

The study authors gathered data from 1994 to 2013 in the United Kingdom and included children who developed JIA, matching them with control participants without an immune disorder.

Not surprisingly, they found that previous exposure to antibiotics was associated with JIA. In fact, 1 or more antibiotic courses were associated in a dose-dependent manner with increased risk of JIA (adjusted odds ratio, 2.1; 95% CI [1.2-3.5]).

Unfortunately, this finding wasn't related to just 1 antibiotic, but all of them.

The researchers found no difference in the rate of JIA and specific antibiotic use. Rather, they found a significant trend toward higher JIA risk with more courses of antibiotics. The greatest correlation was antibiotic use within 1 year of JIA diagnosis.

With more than 11 million inappropriately prescribed antibiotics every year, chances are that every clinician has the opportunity to prevent arthritis in children. When appropriate, clinicians can recommend alternative therapies before providing antibiotics, suggest watching and waiting, and instruct patients to destroy leftover antibiotics to prevent future inappropriate use.

Reference:

Horton DB, et al. Antibiotic Exposure and Juvenile Idiopathic Arthritis: A Case—Control Study. Pediatrics. 136(2);e333-e343.