According to a study by the Journal of the American Medical Association "Pediatrics" (JAMA Pediatrics), the probability of obesity at 5 years is higher in children who receive repeated cycles of broad spectrum antibiotics from 0 to 23 months of life. A similar correlation was not detected in children who received repeated cycles of antibiotics with a narrow spectrum of action, suggesting that the selection of certain types of microflora under the influence of antibiotics might be l one of the modifiable risk factors for childhood obesity.

In a cohort study by L.C. Bailey and colleagues analyzed data from electronic outpatient cards from 64,580 children. Researchers paid special attention to the first 24 months of life, because it is during this period that the most significant changes in children's nutrition and growth, as well as the formation of intestinal microflora, occur. It was found that 69% of children received antibiotics during the first 2 years of life, a third of children did not receive antibacterial drugs.

It was found that in children who received 4 or more doses of antibacterial drugs (ABP) in the first years of life, the relative risk (RR) of obesity at 5 years of age was 11% more higher than in children who did not receive ABP (p = 0.02). After stratification, it was found that during treatment with broad spectrum drugs, the increase in RR was 16% (95% confidence interval - CI 1.06 to 1.29), and during treatment with antibiotics with a narrow spectrum of effects, the RR did not increase.

A feature of this study is that the presence of obesity was studied in children aged 5 years, that is to say still in preschool age. Although the observed effect of using antibiotics at 5 years of age is not too great, the consequences may be greater at an older age.

Previously, the results of another study of the effect of antibiotic therapy at an early age on the dynamics of body weight in children (Trasande L, ea. International Journal of Obesity. 2013; 37: 16- 23) were published, which also showed greater weight gain in children receiving ABP in the first 6 months of their lives.

Without a doubt, the development of obesity is a multifactorial process and we are unable to influence many of its causes. However, the use of broad spectrum antibiotics can be considered as one of the modifiable risk factors for obesity in children. In particular, in the treatment of bacterial infections in children of the first years of life, if possible, preference should be given to drugs with a narrow spectrum of activity that do not affect the body weight of children.