Çocuklukta terapötik antibiyotik kullanımının erken ergenlik riskine etkisi

Yıl 2025, Cilt: 30 Sayı: 3, 435 - 445, 25.09.2025

Leyla Kara

https://doi.org/10.21673/anadoluklin.1660251

Öz

Amaç: Kız çocuklarında erken pubertal gelişim (erken ergenlik) genetik, metabolik ve çevresel faktörlerle ilişkilidir. Erken çocukluk döneminde kullanılan antibiyotiklerin bağırsak mikrobiyotası üzerindeki etkileri nedeniyle pubertal zamanlamayı etkileyebileceği düşünülmekle birlikte, bu konuda kesin kanıtlar bulunmamaktadır. Bu çalışmanın amacı, erken pubertal gelişim gösteren ve göstermeyen kız çocuklarında antibiyotik kullanımı özellikleri (ilk kullanım yaşı, kullanım sıklığı, antibiyotik türleri) arasındaki ilişkiyi araştırmaktır.

Yöntemler: Çalışmaya 6-8 yaş arası 122 kız çocuğu dahil edilmiştir. Katılımcılar klinik, hormonal ve radyolojik değerlendirmelere göre Erken Puberte, Prematür Telarş ve Kontrol gruplarına ayrılmıştır. Antibiyotik kullanımı, ulusal reçete kayıtlarından elde edilmiştir. Gruplar arasında antibiyotik kullanımı açısından farklar ve pubertal parametrelerle ilişkiler istatistiksel olarak incelenmiştir.

Bulgular: Pubertal grup, kontrol grubuna kıyasla daha yüksek vücut ağırlığı, BMI, bazal luteinize hormon (LH) düzeyi ve ileri kemik yaşı göstermiştir (p < 0,05). Antibiyotik kullanım yaşı, toplam kullanım sayısı ve antibiyotik türleri açısından gruplar arasında anlamlı fark bulunmamıştır (p > 0,05). Prematür Telarş grubunda antibiyotiklerin ilk kullanım yaşı ile kemik yaşı arasında zayıf pozitif bir korelasyon tespit edilmiştir. Amoksisilin-klavulanik asit en sık reçete edilen antibiyotik olup, tüm katılımcıların antibiyotik kullanma geçmişi vardır.

Sonuç: Bu çalışmada erken pubertal gelişim gösteren ve göstermeyen kız çocuklarında antibiyotik kullanımı özellikleri açısından fark gösterilmedi. Erken ergenlikte genetik ve metabolik faktörlerin daha belirleyici olduğu düşünülmektedir. Mikrobiyom analizleri ve çevresel maruziyetlerin de dahil edileceği uzunlamasına çalışmalar, bu karmaşık ilişkilerin daha iyi anlaşılması için gereklidir.

Anahtar Kelimeler

Antibiyotikler , çevresel sorunlara maruziyet , erken puberte , kemik yaşı , mikrobiyom , pediatri

Etik Beyan

Kayseri Şehir hastanesi klinik araştırmalar etik kurul tarafından 949 kara numarası ile 28.11.2023 tarihinde etik kurul izni alınmıştır.

Proje Numarası

949

The impact of therapeutic antibiotic use in childhood on the risk of precocious puberty

Öz

Aim: Early pubertal development (precocious puberty) in girls is associated with genetic, metabolic, and environmental factors. Although it is thought that antibiotics used in early childhood may affect pubertal timing due to their impact on the gut microbiota, there is no definitive evidence on this subject. The aim of this study is to investigate the relationship between antibiotic use characteristics (age at first use, frequency of use, types of antibiotics) in girls with and without early pubertal development.

Methods: The study included 122 girls aged 6–8 years. Participants were divided into Early Puberty, Premature Thelarche, and Control groups based on clinical, hormonal, and radiological assessments. Antibiotic use data were obtained from national prescription records. Differences in antibiotic use between groups and correlations with pubertal parameters were analyzed statistically.

Results: The pubertal group showed higher body weight, BMI, basal luteinizing hormone (LH) levels, and advanced bone age compared to the control group (p < 0.05). No significant differences were found between groups in terms of age at first antibiotic use, total number of antibiotic courses, or types of antibiotics used (p > 0.05). A weak positive correlation was found between age at first antibiotic use and bone age in the Premature Thelarche group. Amoxicillin-clavulanic acid was the most frequently prescribed antibiotic, and all participants had a history of antibiotic use.

Conclusion: In this study, no differences were observed in antibiotic use characteristics between girls with and without early pubertal development. Genetic and metabolic factors are believed to play a more decisive role in precocious puberty. Longitudinal studies including microbiome analyses and environmental exposures are necessary to better understand these complex relationships.

Anahtar Kelimeler

Antibiotics , bone age , environmental exposure , microbiome , pediatrics , precocious puberty

Proje Numarası

949

Kaynakça

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