Antibiotics: Had Enough?

How hard can it be to figure out that we’ve had enough — no, too much — of unnecessary antibiotics?

If you need one more reason to believe, look no further than the study published this week in JAMA Pediatrics. Charles Bailey and colleagues conducted a carefully-constructed observational study to compare the risk of obesity in children under two who received narrow-spectrum, broad-spectrum, or no antibiotics. They found that the risk of obesity was higher in children who received antibiotics, especially if they received broad-spectrum antibiotics. The increased risk was about 16%.

Stephen Cook, a noted pediatric obesity expert, emphasized the importance of this study:

Infancy is a vulnerable period for many things. This is a recent cohort, it’s large and worth noticing. It’s nearly impossible to directly test this theory with human children, but studies in animals have found that antibiotic use leads to weight gain.

As Cook noted, this study does not — and likely no other study will — prove a cause and effect relationship between the antibiotics and obesity risk. But suggestive evidence continues to accumulate. What’s more, it’s already clear that overuse of antibiotics does cause plenty of problems.

The most obvious problem is antibiotic resistance, which makes 2 million people in the U.S. sick and kills 23,000 of them every year. But there’s also the fact that unnecessary antibiotics have side effects that are not offset by any medical benefit. Applying a more patient approach — waiting a day or two in many cases — could dramatically reduce unnecessary antibiotic use.

Another source of unnecessary antibiotic use is in livestock production. Such use produces fatter livestock (!) and contributes to antibiotic resistance. FDA has laid out plans for a strictly voluntary phase-out of this practice. But data just released shows that through 2012, the practice was still growing.

Enough is too much. It’s way past time to reserve antibiotics for situations where they are genuinely needed.

Click here to read more in USA Today, click here to read the study, click here to read more about antibiotic overuse in the Washington Post, and click here to read more about increasing sales of antibiotics for use in farm animals.

Infant Karenni Boy, photograph © Joey Marasek / flickr

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