Influence of Alternative Lifestyles on Antibiotic Use during Pregnancy, Lactation and in Children.

Pien Eras,Carel Thijs,Ana Paula Simões-Wüst

doi:10.3390/antibiotics10070837

Pien Eras, Carel Thijs + Show 1 more

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https://doi.org/10.3390/antibiotics10070837

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Abstract

Alternative lifestyles are likely to be associated with distinct usage of specific medicinal products. Our goal was to find out whether the intake of antibiotics during pregnancy and by children differs according to whether the mothers have alternative or conventional lifestyles. Therefore, we investigated the use of antibiotics by pregnant women and by children up to 11 years of age participating in the KOALA Birth Cohort Study. This cohort comprises two recruitment groups of mother–infant pairs, one with alternative lifestyles (selected via organic food shops, anthroposophic clinicians and midwives, anthroposophic under-five clinics, Rudolf Steiner schools and relevant magazines, n = 491) the other with conventional lifestyles (no selection based on lifestyle, n = 2343). Mothers in the alternative lifestyle group more frequently adhered to specific living rules and identified themselves with anthroposophy more than mothers in the conventional lifestyle group. The results revealed significant differences in antibiotic use during pregnancy and in children from 3 months to 10 years of age between the two groups. The rate of antibiotic use in children was consistently lower in the alternative lifestyle group than in the conventional lifestyle group. Antibiotic use in pregnancy was higher in low educated women, and maternal antibiotic use during lactation was higher after an instrumented delivery in hospital. Antibiotic use in the infant was higher when they had older sibs or were born in hospital, and lower in those who had been longer breastfed. After adjustment for these factors, the differences in antibiotic use between the alternative and conventional groups remained. The results suggest that an alternative lifestyle is associated with cautious antibiotic use during pregnancy, lactation and in children.

Highlights

Lifestyles perceived to be distinct from those of the majority of people are often called “alternative lifestyles”
The differences between the two groups with regard to maternal antibiotic use were significant during pregnancy and breastfeeding and continued in their offspring from the beginning, increasing up to age 6–7
Use of penicillin followed the pattern of the remaining antibiotics, except at age two, when use of penicillin was similar in both lifestyle groups

Summary

Introduction

Lifestyles perceived to be distinct from those of the majority of people are often called “alternative lifestyles”. Such lifestyles are frequently supported by underlying ideologies and may influence daily practical decisions, such as those concerning school choice for children, diet composition and use of conventional or complementary medicine therapies and medications. Antibiotics are among the most useful and most problematic medications. Whereas their use in the treatment of bacterial infections has had a markedly favorable impact on public health, this success is clouded by the worryingly increasing spread of antibiotic resistance. According to the WHO (see, e.g., [1]), antibiotic resistance is a major public health problem worldwide, to a large extent caused by the inappropriate and excessive use of antibiotics. Measures to reduce unnecessary use of antibiotics are urgently needed

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