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PLoS One. 2019 May 16;14(5):e0216959. doi: 10.1371/journal.pone.0216959. eCollection 2019.

Chronic antibiotic use during adulthood and weight change in the Sister Study.

Author information

1
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America.
2
Department of Community, Environment, and Policy, University of Arizona, Tucson, AZ, United States of America.
3
Social & Scientific Systems, Inc., Durham, NC, United States of America.
4
Division of Epidemiology, Vanderbilt University Medical Center, Nashville, TN, United States of America.
5
Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, NC, United States of America.

Abstract

BACKGROUND/OBJECTIVES:

Antibiotic use in early life has been associated with weight gain in several populations. However, associations between chronic antibiotic use and weight among adults in the general population are unknown.

SUBJECTS/METHODS:

The NIEHS Sister Study is a longitudinal cohort of sisters of women with breast cancer. We examined associations between chronic antibiotic use (≥ 3 months) during the fourth decade of life (30-39 years) and subsequent obesity at enrollment (mean age = 55) via logistic regression. We also examined associations between chronic antibiotic use in the 5 years and 12 months prior to enrollment and weight gain after enrollment in linear mixed models. Models were adjusted for race/ethnicity, education, urban/rural status, age, and smoking.

RESULTS:

In adjusted analyses (n = 50,237), chronic penicillin use during the 4th decade of life was associated with obesity at enrollment (OR 2.00, 95% CI 1.40, 2.87), and use in the 5 years prior to enrollment was associated with increased BMI change after enrollment (β 1.00 95% CI 0.01, 2.00). Use of bactericidals (OR 1.71, 95% CI 1.29, 2.26) during the 4th decade of life was also associated with obesity at enrollment. Associations for penicillins and bactericidals were consistent across indications for use. Bacteriostatic use in the 5 years prior to enrollment was associated with a reduction in BMI after enrollment (β -0.52, 95% CI -1.04, 0.00), and tetracycline use during the 4th decade of life was associated with reduced odds of obesity at enrollment (OR 0.72, 95% CI 0.56, 0.92). However, these inverse associations were only present for those who reported taking antibiotics for skin purposes. Cephalosporins, macrolides, quinolones, and sulfonamides were not associated with BMI change over time.

CONCLUSIONS:

Chronic use of antibiotics during adulthood may have long-lasting impacts on BMI. Associations may differ by antibiotic class, and confounding by indication may be important for some antibiotic classes.

Conflict of interest statement

MF and DS have no conflicts of interest. SDH is employed by a commercial company, Social and Scientific Systems, Inc. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

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