Association between early-life antibiotics use and the risk of attention-deficit/hyperactivity disorder: A real-world evidence study

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Recently, children using antibiotics showed an increased incidence of neurodevelopmental disorders.

Aims: The purpose of this study was to investigate the association between antibiotics use and the risk of ADHD in children.

Study design: Population-based retrospective cohort study.

Subjects: The Taiwan National Health Insurance Research Database was used to collect data of children. Prevalence of antibiotics use was analyzed in the children (age, <2 years) included in this study. There were 1,601,689 children included in this study between 2004 and 2012.

Outcome measures: The risk of developing ADHD was estimated using the Cox proportional hazards model.

Results: 71.25 % of children used at least one antibiotic, and the mean follow-up period was 7.07 years. After controlling for other related influencing factors, children who used antibiotics had a 1.12 times higher risk of ADHD than those who did not. The risk of ADHD increased through the use of penicillin and cephalosporin regardless of the duration of antibiotics use.

Conclusions: Antibiotics use in children-especially penicillin and cephalosporin-was associated with a higher risk of ADHD.

Keywords: Antibiotics; Attention-deficit/hyperactivity disorder; Children; Gut brain axis; National Health Insurance Research Database; Neurodevelopmental disorder.