Antibiotic use may promote development of Kawasaki disease

Use of antibiotics appears to increase the risk of Kawasaki disease (KD) in children, reveals a study. KD development is potentially driven by gut microbiota changes due to antibiotic use.

A total of 17,818 patients with KD and 89,090 matched controls were included in this study. Use of antibiotics within 6 months (odds ratio [OR], 1.18, 95 percent confidence interval [CI], 1.12‒1.26) and 12 months (OR, 1.23, 95 percent CI, 1.14‒1.32) from the index date correlated with KD development.

This association was most pronounced in patients who had received three or more types of antibiotics within 12 months from the index date (OR, 1.26, 95 percent CI, 1.17‒1.37).

“Antibiotic use within the preceding 6 or 12 months was associated with KD,” the investigators said. “Alteration in gut microbiota due to antibiotic usage might play a role in the development of KD.”

This population-based, case-control study utilized data from the Health Insurance Review and Assessment Service database. The investigators identified children aged <5 years who were diagnosed with KD between 2016 and 2019. They selected propensity score-matched controls from the general population in a 1:5 ratio.

Participants were categorized into four cohorts based on the different periods of antibiotic use: (1) within 28 days and (2) 12 months after birth, (3) within 6 months and (4) 12 months from the index date. Profiles regarding antibiotic use were compared between KD patients and control participants.