29 Marbles: Augmentin and autism: A link?

Another potential cause/trigger for autism is identified in the paper Could one of the most widely prescribed antibiotics amoxicillin/clavulante "Augmentin" be a risk factor for autism? A press release on eMediaWire discusses the "overwhelming response from parents" (emphasis mine):

The author of the seminal paper: Could one of the most widely prescribed antibiotics amoxicillin/clavulanate “AUGMENTIN” be a risk factor for autism? published in Medical Hypotheses January 2005 (64, 312-315) has received thousands of emails, letters and phone calls from parents of children who experienced regressive autism following one or more dosages of Augmentin (amoxicillin/clavulanate).

From one perspective, it seems that the paper is showing that other environmental triggers can be responsible for autism. To me, unfortunately, the last sentence makes these parents look like they'll reach out for anything to blame for their kid's autism. I fear that the anti- bio-med groups will latch onto this to try to remove any serious debate about the topic, much as they are trying to do with the autism-thimerosol question.

Another interesting tidbit from the press release seems to be a linking of what some (Kevin Leitch, for example) consider comorbidities as actual causes of autism (again, the emphasis is mine):

In her paper, the author proposed a mechanism whereby children who received the antibiotic may develop autism as a result of the urea/ammonia toxicity in the gastrointestinal tract. She further links the introduction of augmentin in the early 1980’s for the use in children with otitis media, and the large numbers of children who have autism with protracted ear infections.

I've not had the chance to read the actual paper (actually, I've not been able to find a free full-text version), but here is the abstract from deep within the National Institutes of Health site:

Autism is an ever increasing problem in the United States. Characterized by multiple deficits in the areas of communication, development, and behavior; autistic children are found in every community in this country and abroad. Recent findings point to a significant increase in autism which can not be accounted for by means such as misclassification. The state of California recently reported a 273% increase in the number of cases between 1987 and 1998.

Many possible causes have been proposed which range from genetics to environment, with a combination of the two most likely. Since the introduction of clavulanate/amoxicillin in the 1980s there has been the increase in numbers of cases of autism. In this study 206 children under the age of three years with autism were screened by means of a detailed case history. A significant commonality was discerned and that being the level of chronic otitis media.

These children were found to have a mean number 9.96 bouts of otitis media (with a standard error of the mean of +/-1.83). This represents a sum total for all 206 children of 2052 bouts of otitis media. These children received a mean number of 12.04 courses of antibiotics (standard error of the mean of +/-.125). The sum total number of courses of antibiotics given to all 206 children was 2480. Of those 893 courses were Augmentin. with 362 of these Augmentin courses administered under the age of one year.

A proposed mechanism whereby the production of clavulanate may yield high levels of urea/ammonia in the child is presented. Further an examination of this mechanism needs to be undertaken to determine if a subset of children are at risk for neurotoxicity from the use of clavulanic acid in pharmaceutical preparations.