Association between use of multiple classes of antibiotic in infancy an allergic disease in childhood

1. Commonly prescribed antibiotics in infancy are associated with later diagnosis of allergic disease in childhood

Evidence Rating Level: 2 (Good)

The use of antibiotics negatively impacts the human microbiome, decreasing bacterial diversity. These kinds of changes to the microbiome have been previously found to be associated with allergic disease. In this retrospective cohort study, 798,426 children (Department of Defense Tricare beneficiaries) were followed up for the presence of any allergic disease and/or related conditions (i.e. anaphylaxis, asthma, atopic dermatitis) to determine whether exposure to multiple antibiotic classes in infancy is associated with a higher risk of developing allergic disease in early childhood. Researchers found that all the antibiotic types assessed were associated with an increased risk of allergic disease in childhood, including penicillin (HR 1.30, 95% CI 1.28 to 1.31), penicillin with a β-lactamase inhibitor (HR 1.21, 95% CI 1.18 to 1.23), cephalosporins (HR 1.19, 95% CI 1.17 to 1.21), sulphonamides (HR 1.06, 95% ci 1.03 to 1.10) and macrolides (HR 1.28, 95% CI 1.26 to 1.30). Children prescribed an additional class of antibiotic demonstrated a further increased likelihood of later developing allergic disease. This study therefore shows that commonly prescribed antibiotics used in infancy are associated with later diagnosis of allergic disease in childhood.