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Published on: May 10, 2024
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.
Background:
Cohort studies have suggested that early-life antibiotic treatment is associated with increased risk of atopy. We determined whether antibiotic treatment already in the first week of life increases the risk of atopic and non-atopic disorders.
Methods:
The INCA study is a prospective observational birth cohort study of 436 term infants, with follow-up of 1 year; 151 neonates received broad-spectrum antibiotics for suspected neonatal infection (AB+), vs a healthy untreated control group (N = 285; AB-). In the first year, parents recorded daily (non-) allergic symptoms. At 1 year, doctors' diagnoses were registered and a blood sample was taken (n = 205).
Results:
Incidence of wheezing in the first year was higher in AB+ than AB- (41.0% vs 30.5%, P = .026; aOR 1.56 [95%CI 0.99-2.46, P = .06]). Infantile colics were more prevalent in AB+ compared to AB- (21.9% and 14.4% P = .048), and antibiotic treatment was an independent risk factor for infantile colics (aOR 1.66 (95%CI 1.00-2.77) P = .05). Allergic sensitization (Phadiatop >0.70kUA/L) showed a trend toward a higher risk in AB+ (aOR 3.26 (95%CI 0.95-11.13) P = .06). Incidence of eczema, infections, and GP visits in the first year were similar in AB+ and AB-.
Conclusion:
Antibiotic treatment in the first week of life is associated with an increased risk of wheezing and infantile colics. This study may provide a rationale for early cessation of antibiotics in neonates without proven or probable infection.
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