Antibiotics Early in Life Linked to Childhood Atopy

TOPLINE:

Exposure to antibiotics for an infection in the first week of life, or exposure to antibiotics within the first 6 months, is associated with a higher risk for childhood atopic disease.

METHODOLOGY:

• A population-based, prospective birth cohort study of 11,255 children born of singleton pregnancies in Southwest Finland between 2008 and 2010.
• Authors examined antibiotic exposure among participants from birth to age 6 months and measured maximum plasma C-reactive protein (CRP) concentration in first week of life in about 12% of participants.
• Outcomes of interest were physician diagnosis of atopic dermatitis, asthma, or use of inhaled corticosteroid medication up to age 8 or 9 years.
• To reduce confounding by indication, the authors controlled for having older siblings, pre-pregnancy maternal body mass index, smoking during pregnancy, pregnancy duration, vaginal vs caesarean delivery, child’s sex, and intrapartum antibiotic exposure.

TAKEAWAY:

• In all, 11.2% of participants were exposed to antibiotics during the first 14 days of life and 15.8% by age 6 months.
• Neonatal antibiotic exposure for confirmed infection, but not brief empiric treatment, was associated with significantly higher odds of later atopic dermatitis diagnosis.
• High neonatal CRP was not associated with later diagnoses.
• Antibiotic exposure up to age 6 months was also associated with higher odds of later atopic dermatitis, childhood asthma, and inhaled corticosteroid prescriptions.

IN PRACTICE:

“These data suggest that the duration of neonatal antibiotic exposure may play a more important role in the development of atopic disease than the underlying infection and inflammatory response,” the authors wrote.

SOURCE:

Conducted by a Finnish team, the study appeared in European Journal of Pediatrics.

LIMITATIONS:

A possible residual confounders. Causal link is not proven; if one is present, mechanism is not clear.

DISCLOSURES:

The authors declared they had no competing interests.