BioMedicine · 2026
Early-life exposure to antibiotics increases the risk of myopia: A retrospective cohort study.
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Tien Peng-Tai, Wei Chang-Ching, Lin Sheng-Chun, Meng Ping Ping, Huang Yu-Te, Chen Jamie Jiin-Yi, Wu Ming-Yen, Shih Ying-Hsiu, Hsu Tzu-Ju, Tsai Fuu-Jen, Wang Yao-Chien, Lin Hui-Ju, Wan Lei
Аннотация
BACKGROUND: The prevalence of myopia is increasing worldwide and is projected to affect nearly half of the global population by 2050. Although genetic susceptibility plays an important role, early-life environmental exposures are increasingly recognized as modifiable contributors to myopia development. Antibiotics are frequently prescribed during infancy and early childhood and can alter gut microbiota composition, which has been implicated in ocular disorders.
METHODS: We conducted a retrospective cohort study using data from a national health insurance database. Children aged three years or younger who received systemic antibiotics were included, while those with pre-existing myopia or retinopathy were excluded. Antibiotic-exposed children were matched with non-exposed controls by age, sex, and relevant comorbidities. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incident myopia.
RESULTS: Early-life antibiotic exposure was associated with a significantly increased risk of myopia compared with non-exposed controls (aHR = 1.03; 95% CI: 1.02-1.04), accompanied by a higher cumulative incidence of myopia (log-rank test, p < 0.001). The elevated risk was observed in both females (incidence rate [IR] = 66.98 vs. 64.10; aHR = 1.05; 95% CI: 1.04-1.07) and males (IR = 61.53 vs. 59.66; aHR = 1.04; 95% CI: 1.02-1.05). Urbanization level, parental monthly income, and comorbidities were independently associated with antibiotic exposure. The increased risk of myopia persisted irrespective of antibiotic treatment duration (<11 days; aHR = 1.19; 95% CI: 1.15-1.23) or cumulative dose (defined daily dose <2833; aHR = 1.31; 95% CI: 1.28-1.33).
CONCLUSIONS: Early-life exposure to antibiotics is associated with a higher incidence of myopia in children. These findings underscore the importance of cautious and judicious antibiotics prescribing during early childhood to mitigate potential long-term ocular health risks.
METHODS: We conducted a retrospective cohort study using data from a national health insurance database. Children aged three years or younger who received systemic antibiotics were included, while those with pre-existing myopia or retinopathy were excluded. Antibiotic-exposed children were matched with non-exposed controls by age, sex, and relevant comorbidities. Cox proportional hazards regression models were used to estimate adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for incident myopia.
RESULTS: Early-life antibiotic exposure was associated with a significantly increased risk of myopia compared with non-exposed controls (aHR = 1.03; 95% CI: 1.02-1.04), accompanied by a higher cumulative incidence of myopia (log-rank test, p < 0.001). The elevated risk was observed in both females (incidence rate [IR] = 66.98 vs. 64.10; aHR = 1.05; 95% CI: 1.04-1.07) and males (IR = 61.53 vs. 59.66; aHR = 1.04; 95% CI: 1.02-1.05). Urbanization level, parental monthly income, and comorbidities were independently associated with antibiotic exposure. The increased risk of myopia persisted irrespective of antibiotic treatment duration (<11 days; aHR = 1.19; 95% CI: 1.15-1.23) or cumulative dose (defined daily dose <2833; aHR = 1.31; 95% CI: 1.28-1.33).
CONCLUSIONS: Early-life exposure to antibiotics is associated with a higher incidence of myopia in children. These findings underscore the importance of cautious and judicious antibiotics prescribing during early childhood to mitigate potential long-term ocular health risks.