Use of antibiotics in childhood and risk of Type 1 diabetes: a population‐based case–control study

Aims To investigate whether the use of antibiotics from infancy to adolescence influences the risk of Type 1 diabetes. Methods We conducted a population‐based case–control study, including all Type 1 diabetes cases in Denmark among children born between 1997 and 2012 (n = 1578). Odds ratios associating Type 1 diabetes with use of antibiotics were calculated using conditional logistic regression. Results Overall, we found no association between the use of antibiotics and risk of Type 1 diabetes. Furthermore, no associations were seen specifically for broad‐spectrum, narrow‐spectrum, bactericidal or bacteriostatic types of antibiotics or for the most frequently used individual classes of antibiotics. No differences were observed in subgroups defined by sex or by age at time of diagnosis. However, filling five or more antibiotic prescriptions in the first 2 years of life specifically was associated with a higher odds ratio of 1.35 (95% CI 1.10–1.64). This association appeared to be driven by exposure to broad‐spectrum antibiotics within the second year of life. Conclusion Antibiotic exposure in childhood is generally not associated with the risk of developing Type 1 diabetes. Future studies should investigate the effects of multiple exposures to broad‐spectrum antibiotics during the second year of life. What's new? Using data from three Danish registers we performed a nationwide case–control study of the association between antibiotic exposure in childhood and development of Type 1 diabetes in Danish children and adolescents. Overall, no association was seen between use of antibiotics and risk of Type 1 diabetes, irrespective of type of antibiotic used. A positive association was, however, seen between Type 1 diabetes and exposure to broad‐spectrum antibiotics in the first 2 years of life.