Antibiotic prescription and food allergy in young children

Area of Science:

• Pediatric Allergy and Immunology
• Microbiome Research
• Pharmacoepidemiology

Background:

• Early-life antibiotic exposure is a growing concern in pediatric health.
• Understanding the link between antibiotics and food allergy (FA) is crucial for public health.
• Existing research suggests potential associations, but further investigation is warranted.

Purpose of the Study:

• To investigate the association between early-life systemic antibiotic prescriptions and the diagnosis of food allergy (FA).
• To quantify the risk of FA associated with varying numbers of antibiotic prescriptions in the first year of life.

Main Methods:

• A matched case-control study utilizing South Carolina Medicaid administrative data.
• Cases (food allergy diagnosis) and controls (no food allergy) were matched on birth month/year, sex, and race/ethnicity.
• Conditional logistic regression analysis was employed, adjusting for asthma, wheeze, and atopic dermatitis.

Main Results:

• 1504 food allergy cases and 5995 controls were analyzed.
• Antibiotic prescription within the first 12 months of life was associated with an increased odds of FA diagnosis (aOR 1.21).
• A dose-response relationship was observed, with five or more prescriptions showing a significant association (aOR 1.64).
• Cephalosporins and sulfonamides demonstrated the strongest associations with FA diagnosis.

Conclusions:

• Systemic antibiotic use in the first year of life is significantly associated with subsequent food allergy diagnosis in children.
• The risk of food allergy increases with the number of antibiotic prescriptions received during infancy.
• These findings highlight the importance of judicious antibiotic stewardship in early childhood.