Gastrointestinal Symptoms and Oral Antibiotic Use in Children with Autism Spectrum Disorder: Retrospective Analysis of a Privately Insured U.S. Population.
Troy Vargason, Deborah L McGuinness, Juergen Hahn
PMID 30178105WHAT IT FOUND
Children with ASD had more gastrointestinal diagnosis claims than children without ASD: 37.0% versus 20.0%.
More early antibiotic fills were also associated with later gastrointestinal diagnosis claims. This is an association, not proof antibiotics caused symptoms.
Key findings
01During the late enrollment period, 37.0% of children with ASD and 20.0% of children without ASD had a gastrointestinal diagnosis claim.
02More oral antibiotic fills during the first three years were associated with a higher adjusted hazard ratio for a later gastrointestinal diagnosis; the adjusted hazard ratio was 1.48 for 7 to 9 fills.
03Early antibiotic fills showed a similar association with later gastrointestinal claims in children with ASD and children without ASD.
STILL TO COME
How it was doneWhat they found
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What it does not show
The study used insurance claims, so a diagnosis claim may not equal a confirmed gastrointestinal symptom. Gastrointestinal diagnoses may be under-reported in claims data. Prescriptions filled may not have been taken. The index date was not the exact birth date, so the timing of early exposure is approximate. The time-to-event analysis used a 10 to 1 matched subset of the general population cohort, not the full cohort. No outpatient visit counts were adjusted for, so more frequent medical contact could influence some differences. The authors state the study cannot show causation. Data did not include antibiotic class, maternal antibiotic use, or family socioeconomic factors. The sample was limited to privately insured children.
Declared interests
The authors declared that they have no conflict of interest.
The easy way to misread this
Do not conclude that early antibiotics caused gastrointestinal symptoms. The study is retrospective, uses insurance claims, and the authors state that only correlative conclusions can be made.