To the complete surprise of my parents, I was born two months premature — so, needless to say, the headline "Too many antibiotics can give preemies a lifetime of ill health” caught my attention.
Antibiotics are the source of a lot of fear and confusion these days
Everyone knows that antibiotic resistance is theoretically rising, but willingness to forego antibiotics is not quite as strong (as if it were even fully clear who shouldn’t take them and when, which it isn’t).
To make a long story short: basically every preemie in the U.S. currently ends up receiving antibiotics, sometimes for weeks on end, because the risks of infection (even just suspected infection) loom much larger than the possible risks of antibiotics themselves.
What does all this early antibiotic exposure do?
For one thing, it disrupts the normal development of the gut microbiome, though we don’t exactly know what health problems those microbiome changes go on to cause (maybe asthma, maybe obesity). In preemies, it will be difficult to tease apart which health problems are related to prematurity, which are caused by the same risk factors that cause prematurity, and which are related to antibiotics and other treatment early in life.
Early antibiotic exposure in preemies also leaves their guts over-colonized by the hardy, dangerous bugs instead. So preventing some bacterial illness now, through antibiotics, might just set them up to catch (or pass on) other bacterial illness a little later.
Do these concerns apply to regular, full-term babies who receive antibiotics?
Probably not exactly. Researchers have found that a higher/longer dose of antibiotics means more microbiome change. So, babies who spend time in the NICU and who receive prophylactic antibiotics have more time & opportunity to acquire nasty hospital-borne bacteria in place of the normal stuff.
It does seem that the cure is sometimes worse than the disease, especially for preemies. But for full-term babies who acquire known infections that are readily treatable with short-term antibiotics, the benefits of antibiotics still outweigh the risks.