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

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.