Antibiotic administration and the development of obesity in children

• Antibiotic abuse can cause gut microbiota dysbiosis.
• Antibiotic-related gut microbiota dysbiosis is associated with obesity.
• Obesity should be considered a reason for the judicious use of antibiotics.
• Probiotics and prebiotics can improve the balance of the intestinal flora.
• Further studies on the relationship between antibiotics and dysbiosis are needed.

Antibiotics are the most common prescription drugs administered at the paediatric age, however their administration can cause unwanted problems. Among these issues, antibiotic-induced gut microbiota dysbiosis has appeared as an emerging issue and has been associated with obesity. This problem is particularly relevant in children because they are frequently treated with antibiotics. Early development of obesity increases the risk of adult obesity, which is associated with the emergence of very severe clinical problems. Dysbiosis induced in the first periods of life can have the most relevant practical consequences because a decrease in the number of microbes and their substitution with other microbes dramatically modifies the development of the immune system as well as glucose and lipid metabolism. Unfortunately, not all of the mechanisms that could explain the relationship between gut microbiota modification and the development of obesity have been defined. Consequently, no definitive therapeutic approach has been elucidated. Probiotics and prebiotics could play a role in treating microbial dysbiosis because the addition of specific bacterial strains has been associated with normal weight and has been demonstrated to be useful in clinical conditions other than obesity that are caused by microbiota disruption. Considering that antibiotics are commonly prescribed and that obesity is increasing in paediatric patients, further studies specifically designed to evaluate how to disrupt the relationship between antibiotics and dysbiosis are urgently needed. Presently, paediatricians have to consider dysbiosis to be a new and serious reason for the judicious use of antibiotics in clinical practice.