All commonly prescribed antibiotics use during infancy is associated with subsequent diagnosis of allergic disease and administration of more than one class of antibiotic increases the risk, most notably for asthma and allergic rhinitis. The is the finding of a new study published in JAMA Pediatrics.
The retrospective cohort study included 798,426 children. Exposures were defined as having any dispensed prescription for penicillin, penicillin with a β-lactamase inhibitor, cephalosporin, sulphonamide or macrolide in the first six months of life. Analyses were adjusted for caesarean delivery, prematurity, sex, antacid medication exposure and total days of supplied antibiotics.
All types of antibiotic classes assessed were found to be associated with a significant increased risk for allergic disease. The risks were lowest for sulphonamides (adjusted HR [aHR], 1.06; 95% CI, 1.03-1.10) and 1.19 or greater for all other classes (aHR range for cephalosporin, 1.19; 95% CI, 1.17-1.21 to 1.30; 95% CI, 1.28-1.31 for penicillin).
Children prescribed an additional class of antibiotic had increased aHRs for each subtype of allergic disease, particularly asthma (aHR, 1.47; 95% CI, 1.45-1.49) and allergic rhinitis (aHR, 1.33; 95% CI, 1.32-1.34).
The findings suggest caution should be used regarding the prescribing of antibiotics in infants.
