Wheezing and infantile colic are associated with neonatal antibiotic treatment

Berthe C Oosterloo1, Ruurd M van Elburg1,2, Nicole B Rutten3

  • 1Academic Medical Center, Emma Children's Hospital, Amsterdam, the Netherlands.

Insights

Early antibiotic use in newborns is linked to higher risks of infantile colics and wheezing. This suggests caution with antibiotic prescriptions for infants not confirmed to have infections.

Area of Science:

  • Neonatal medicine
  • Pediatric allergy
  • Microbiome research

Background:

  • Previous cohort studies suggest a link between early-life antibiotic exposure and increased atopy risk.
  • The study investigates if antibiotic treatment within the first week of life elevates the risk of atopic and non-atopic conditions in infants.

Purpose of the Study:

  • To determine the association between early-life antibiotic exposure and the incidence of atopic and non-atopic disorders in the first year of life.
  • To evaluate the impact of neonatal antibiotic treatment on infant health outcomes, including allergic sensitization and common infant ailments.

Main Methods:

  • Prospective observational birth cohort study (INCA study) involving 436 term infants followed for one year.
  • 151 neonates received broad-spectrum antibiotics (AB+), compared to 285 untreated controls (AB-).
  • Daily symptom recording by parents, physician diagnoses, and blood sample analysis at one year were utilized.

Main Results:

  • Higher incidence of wheezing in the first year for the antibiotic-exposed group (41.0% vs 30.5%).
  • Infantile colics were more prevalent in the AB+ group (21.9% vs 14.4%), with antibiotic treatment identified as an independent risk factor.
  • A trend towards higher allergic sensitization was observed in the AB+ group (aOR 3.26).

Conclusions:

  • Antibiotic treatment during the first week of life is associated with an increased risk of wheezing and infantile colics.
  • Findings support the cautious use of antibiotics in neonates, advocating for early cessation in cases without confirmed or probable infection.
Abstract

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