Current Evidence Regarding Antibiotic Exposure and Childhood Obesity: An Integrative Review
Gayle J. Early
The high prevalence of overweight and obesity in children compels healthcare
providers to attempt to modify all possible risk factors. The purpose of this review
is to synthesize research focused on antibiotic exposure in children and possible
effects on body mass index (BMI) percentiles. The mechanism of weight gain
associated with antibiotic exposure is theorized to be associated with changes in
the gut microbiota. A search of PubMed, Medline, CINAHL, and ResearchGate
ultimately revealed nine original research articles directly examining the relationship
of antibiotics to obesity in children. The evidence reported (January 2011 to
July 2016), using large samples and cohort methods, is predominantly Level IV.
Study results varied, as well as ages for antibiotic exposure and BMI endpoints,
along with definitions for categorizing antibiotics. Reports indicate that the first
two years of life are the most vulnerable to antibiotic influence; however, recent
research indicates an effect later in childhood as well. Frequent exposure and
broad spectrum antibiotics seem to have more effect on BMI, and that effect may
be greater in boys than in girls. Nurse clinicians have an opportunity to modify a
potential risk factor for obesity with awareness of sound antibiotic stewardship.
Research is needed to explore possible racial and ethnic differences in this area
and persistence of BMI effects over time.