Antibiotic Overuse in Children: An Ayurvedic View on Gut Health, Agni, and Immunity — A Critical Review

Antibiotics rank among the most commonly prescribed medications in pediatric care. Although they are life-saving, their excessive use has raised concerns regarding long-term health effects, especially in children. Inappropriate and excessive antibiotic use in children has emerged as a major global health concern due to increasing antimicrobial resistance, gut microbiome disruption, recurrent infections, allergic disorders, and impaired immune development. Early life alterations in intestinal microbial ecology may have long-term metabolic, immunological, and neurodevelopmental consequences. Ayurveda, a traditional medical system, offers a comprehensive framework for understanding these changes through the concepts of Agni (digestive and metabolic capacity), Ama (toxic metabolic byproducts), and Ojas (the vital essence that supports immunity). Disturbance of digestive homeostasis due to improper diet, medications, and recurrent illness is believed to produce Ama formation and impaired tissue nourishment, predisposing children to recurrent disease. This review aims to provide a systems-based integrative perspective on the overuse of antibiotics in children by linking microbiome disturbances with Ayurvedic principles. Literature from classical Ayurvedic texts and contemporary databases, including PubMed, Scopus, and Web of Science was reviewed. Evidence suggests that repeated antibiotic exposure during childhood is associated with dysbiosis, reduced microbial diversity, obesity, inflammatory bowel disease, asthma, and immune dysregulation. Ayurvedic interventions, including Deepana-Pachana, Rasayana, dietary regulation, and microbiome-supportive practices, may help restore gut health and immune balance. Additionally, this article examines potential preventive and restorative strategies rooted in Ayurveda to enhance pediatric health.