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

Abstract

BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Recently, children using antibiotics showed an increased incidence of neurodevelopmental disorders. AimsThe purpose of this study was to investigate the association between antibiotics use and the risk of ADHD in children. Study designPopulation-based retrospective cohort study. SubjectsThe 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 measuresThe risk of developing ADHD was estimated using the Cox proportional hazards model. Results71.25 % 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. ConclusionsAntibiotics use in children—especially penicillin and cephalosporin—was associated with a higher risk of ADHD.