Antibiotic Overprescription: Early Antibacterial Treatment Could Decrease Newborns' Gut Microbiome, Increase Antimicrobial Resistance

Antibiotic treatments are essential for babies during their first week after birth. The administration of antibiotics is proven to be effective on the child's health. A new study discovered that early-life treatments using antibiotics could cause a decrease in babies' developing gut microbiome that work for milk digestion and increase their antimicrobial resistance.

Antibiotic Prescription for Infants

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This photo taken on May 10, 2020 shows paediatrician Anisa Rahmadhani (L) and nurse Nur Saidah (R) giving a vitamin injection to newborn baby Bellvania Magdalena Sianturi following her birth at the RSIA Tambak maternity clinic in Jakarta. - As frontline hospital staff are constantly facing the risks from the COVID-19 coronavirus outbreak, the world marks International Nurses Day on May 12. During the COVID-19 coronavirus outbreak, hospitals in Indonesia are only allowing one birth support person during deliveries, with the rules constantly changing as cases spike. ADEK BERRY/AFP via Getty Images

Experts suggest that clinicians must consider utilizing particular antibiotics for infants due to their effects on the newborns' microbiome.

The current health guidelines show that four to 10 percent of newborns suspected of infections received antibiotics.

However, the authors of the recent study believed that most infant cases are prescribed unnecessary antibiotics. Some of these treatments even have little to no impact on their health. Only a small population of those administered with antibiotics are diagnosed with the target infection.

The overprescription serves as an approach for clinicians to assure treatment as early as the first week in case of life-threatening infections.

Researchers from the Universities of Edinburgh and Birmingham, and the Spaarne Hospital and University Medical Centre Utrecht, The Netherlands, conducted a clinical trial to identify how antibiotic treatments relate to the shifts in a newborn microbiome. The study involved 227 infants.

Of the total subjects, 147 babies suspected of sepsis received one of the three common antibiotic drugs. Observation from this group was compared with the participants who have not been prescribed the treatments and were not suspected of infections, MedicalXpress reports.

Antiobiotics Affect Gut Microbiome of Babies

The group of newborns who received antibiotics showed a significant decline of various Bifidobacterium species on their system, as opposed to the infants who did not receive any drug treatments.

Bifidobacterium species are the microbes responsible for assisting the gut in digesting breast milk. It is also a huge factor in strengthening immune defense from hostile infections. Disease-causing bacterias and genes linked to antimicrobial resistance also increased.

The study noticed changes in 251 of the 695 total bacteria examined after early treatment. When the balance between good and bad microbiome is disrupted, harmful bacteria could infiltrate the gut system.

Wilhelmina Children's Hospital and University Medical Center Utrecht's Department of Pediatric Immunology and Infectious Diseases expert Debby Bogaert, who authored the study, said that their team was surprised by the magnitude of the broad-spectrum antibiotics in newborn babies compared to the effect of the same treatments to the adult gut system.

Bogaert explained that the effects are due to administering the antibiotic treatments to newborns even if they have just received their first set of microbiome from their parents. The infants' microbiome is not yet developed to withstand the intensities of any treatments.

The study tested three antibiotic treatment regimens and found out that the combination of penicillin and gentamicin have the least detrimental effect on the baby's gut microbiome and number of antimicrobial resistance genes that emerge. So, the researchers conclude that the said combination of antibiotics should be preferably prescribed when treating suspected infection in babies.

The study titled "Effects of early-life antibiotics on the developing infant gut microbiome and resistome: a randomized trial" was published in Nature Communications.


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