Early Life Exposure to Antibiotics and Autism Spectrum Disorders: A Systematic Review.
Jan Łukasik, Bernadeta Patro-Gołąb, Andrea Horvath and 2 others
PMID 31175505WHAT IT FOUND
Evidence linking early-life antibiotics to autism is inconclusive.
Large cohort studies show conflicting results, and case-control studies suffer from recall bias. Current data does not support changing antibiotic prescribing practices for autism prevention.
Key findings
01A meta-analysis of cohort studies found no significant association between postnatal antibiotic exposure and autism diagnosis.
02Case-control studies reporting positive associations were limited by recall bias and small sample sizes.
03It is difficult to determine if observed risks are due to antibiotics or the underlying infections they treated.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
Only 11 studies met inclusion criteria, resulting in small subgroups for analysis. Most included studies were case-control designs, which are prone to recall bias (parents of children with ASD may report exposures differently than control parents). Several large cohort studies used overlapping populations, limiting the independence of the data. The review could not distinguish whether associations were caused by antibiotics or the underlying infections requiring treatment. Heterogeneity in how antibiotic types and timing were reported prevented a comprehensive meta-analysis for specific drug classes.
The easy way to misread this
Do not conclude that antibiotics cause autism or are protective against it. The evidence is conflicting and largely inconclusive, with significant bias in the studies showing positive associations.