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Previous antibiotic use and the development of Kawasaki disease: a matched pair case-control study

Mitsuharu Fukazawa1,2, Mitsuru Fukazawa1,2, Etsuro Nanishi2

  • 1Fukazawa Pediatric Clinic, Fukuoka, Japan.

Pediatrics International : Official Journal of the Japan Pediatric Society
|April 20, 2020
PubMed

Insights

Previous antibiotic use significantly increases Kawasaki disease (KD) risk in children. Antibiotics may alter gut microbiota, contributing to KD development and vasculitis.

Area of Science:

  • Pediatric Rheumatology
  • Microbiome Research
  • Infectious Diseases

Background:

  • Kawasaki disease (KD) is a critical pediatric illness causing systemic vasculitis with unknown etiology.
  • Altered gut microbiota are increasingly recognized as potential contributors to KD pathogenesis.

Purpose of the Study:

  • To investigate factors associated with intestinal dysbiosis in children with Kawasaki disease.
  • To identify potential triggers for KD development.

Main Methods:

  • An age- and gender-matched case-control study involving 50 KD patients and 200 controls.
  • Conditional multivariable logistic regression analysis to determine associations.

Main Results:

  • Previous antibiotic administration was strongly associated with KD onset (OR 11.7, P < 0.0001).
  • Cesarean birth was an additional risk factor in infants under 12 months (OR 8.0, P = 0.005).
  • Breastfeeding and group nursery attendance were not significant factors.

Conclusions:

  • Previous antibiotic exposure is a significant risk factor for Kawasaki disease.
  • Antibiotics may promote KD by negatively impacting the gut microbiota in young children.
Abstract

Keywords:
Kawasaki diseaseantimicrobial stewardshipinnate immunitymicrobiota

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