Antibiotic treatment during early childhood and risk of type 1 diabetes in children: A national birth cohort study

Julie Christine Antvorskov, Camilla Schmidt Morgen, Karsten Buschard, Tine Jess, Kristine Højgaard Allin, Knud Josefsen

5 Citations (Scopus)


AIM: Antibiotics are widely used during childhood infections and influence the composition of the microbiota, which is established during the first years of life. Evidence from animal models of type 1 diabetes shows that antibiotics might accelerate disease progression, and altered intestinal microbiota has been reported in association with type 1 diabetes in humans. We aimed to test the hypothesis that early exposure to antibiotics (0-24 months of age) was associated with an increased risk of childhood type 1 diabetes development.

METHODS: We studied 75 615 mother-child dyads from the Danish National Birth Cohort. Information on the use of antibiotics during early childhood and type 1 diabetes development in childhood was available for all children via linkage to the Danish National Prescription Registry and the Danish National Patient Register, respectively. The mean follow-up time was 14.3 years (range 11.5 to 18.4 years, SD 1.4).

RESULTS: After adjustment for confounders, we found no association between antibiotic exposure and risk of type 1 diabetes (HR 1.26, 95% CI 0.89-1.79). The number of antibiotic courses during early childhood was not associated with type 1 diabetes development when analyzing for one (HR 1.31, 95% CI 0.87-1.99), two (HR 0.99, 95% CI 0.61-1.63), or 3 or more (HR 1.42, 95% CI 0.95-2.11) courses. Furthermore, no specific types of antibiotics (penicillins/beta-lactam antibacterials, sulfonamide/trimethroprim or macrolides/lincosamides/streptogramins) were associated with increased risk of type 1 diabetes.

CONCLUSION: Our nationwide cohort study suggests that postnatal exposure to antibiotics does not influence the development of childhood type 1 diabetes. This article is protected by copyright. All rights reserved.

Original languageEnglish
JournalPediatric Diabetes
Issue number8
Pages (from-to)1457-1464
Number of pages8
Publication statusPublished - Dec 2020


  • antibiotics
  • children
  • early childhood
  • postnatal exposure
  • type 1 diabetes


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