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.
 
Send comments and news tips to [email protected].