Common Antibiotics May Not Cause Type 1 Diabetes, Celiac Disease

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Antibiotics were previously thought to increase the incidence of certain autoimmune diseases.

Antibiotics may not be responsible for the onset of type 1 diabetes (T1D) or celiac disease among pediatric patients who have a high risk of developing the condition, according to a new study published by JAMA Pediatrics.

Common antibiotics have been thought to increase the incidence of autoimmune disease, which places a greater priority on understanding the relationship between the drugs and these conditions. Previous studies in humans have shown inconsistent results between antibiotic use and T1D.

In both conditions, the immune system launches an attack against the body. The immune system kills insulin-producing cells in T1D, while it attacks the small intestine in response to gluten in celiac disease. Both conditions are life-long and incurable.

The aim of the study was to determine whether antibiotics used to treat common childhood infections could result in the onset of autoimmune diseases.

“I thought we should get to the heart of the matter because you want parents to know whether their children are going to be put at risk when a physician prescribes an antibiotic,” said researcher Eric Triplett, PhD.

Included in the study were 8495 children who had a genetic risk of developing T1D and 6558 children who had a genetic risk of developing celiac disease. Parents reported when or if their children took penicillin, amoxicillin, and cephalosporin between the ages 3 months to 4 years.

Before age 4, the study participants were prescribed antibiotics more than 38,000 times, with amoxicillin as the most common drug. The authors reported that macrolide and beta-lactam antibiotics accounted for 70.5% of all antibiotics.

The investigators discovered that 5.5% of children developed T1D immunity and 11.6% developed celiac disease immunity before 4 years of age, according to the study.

However, the authors concluded that antibiotic use was not linked to the creation of antibodies in at-risk children.

“We have no evidence that pediatric use of antibiotics affects the risk of type 1 diabetes or celiac disease in either direction. It doesn’t increase or decrease the risk,” said co-author Kaisa M. Kemppainen, PhD.

The authors advise parents not to forego antibiotic treatment for children at-risk of developing T1D or celiac disease due to these concerns, according to the study. Forgoing antibiotics may result in serious infections and can cause adverse health events.

“Don’t worry about the standard antibiotics for children under age 4,” Dr Triplett said. “If you’re concerned and there is a history of type 1 diabetes or celiac disease in your family, antibiotics are not going to contribute to the risk of developing the disease.”

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