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Antibiotic Exposure and the Risk of Food Allergy: Evidence in the US Medicaid Pediatric Population
Minghui Li1, Z Kevin Lu2, David J Amrol3
1Department of Clinical Pharmacy and Translational Science, College of Pharmacy, The University of Tennessee Health Science Center, Memphis, Tenn.
Insights
Early antibiotic exposure in children is linked to a faster development of food allergies. This study found a 40% increased risk in children who received antibiotic prescriptions, highlighting a significant public health concern.
Area of Science:
- Pediatric Health
- Immunology
- Public Health
Background:
- Food allergy is a growing public health issue, particularly affecting children in the U.S.
- Early life antibiotic exposure is a suspected risk factor for developing food allergies.
- Food allergies impose significant clinical and economic burdens on healthcare systems.
Purpose of the Study:
- To investigate the association between early-life antibiotic exposure and the timing of food allergy development.
- To quantify the impact of antibiotic use on the onset of food allergies in pediatric populations.
Main Methods:
- A population-based, matched cohort study utilized Medicaid data from 28 U.S. states.
- Antibiotic nonusers were matched 1:1 with antibiotic users based on demographics and location.
- Cox proportional hazards regression models analyzed the effect of antibiotic exposure on time to food allergy diagnosis.
Main Results:
- Over 1 million children were included, with 500,647 antibiotic nonusers matched to 500,647 antibiotic users.
- Antibiotic exposure was significantly associated with a faster development of food allergy (HR, 1.40; 95% CI, 1.34-1.45).
- Findings remained consistent across sensitivity analyses and were observed in 17 of 28 states.
Conclusions:
- Children with antibiotic prescriptions showed an increased risk of developing food allergies compared to nonusers.
- Early antibiotic use is a significant risk factor for the accelerated onset of food allergies in children.
Background:
Food allergy is a significant public health concern in the United States, especially in the pediatric population. It places substantial clinical and economic burdens on the health care system. Exposure to antibiotics in early childhood is thought to increase the risk of subsequent food allergy.
Objective:
To examine the impact of exposure to antibiotics early in life on time to development of food allergy.
Methods:
We conducted a population-based matched cohort study using Medicaid data from 28 states. Antibiotic nonusers were matched 1:1 to antibiotic users on date of birth, sex, race, and state. A Cox proportional hazards regression model was used to evaluate the effect of antibiotic exposure on time to development of food allergy. Sensitivity analyses were performed to assess the robustness of study findings.
Results:
We matched 500,647 antibiotic nonusers to 500,647 antibiotic users in the Medicaid pediatric population. In the adjusted Cox proportional hazards regression analysis, antibiotic exposure was significantly associated with faster development of food allergy (hazard ratio, 1.40; 95% CI, 1.34-1.45). The magnitude and significance of the association between antibiotic exposure and food allergy did not change in the sensitivity analyses. A significant association between antibiotic exposure and faster development of food allergy was found in 17 of 28 states.
Conclusion:
Compared with antibiotic nonusers, children with antibiotic prescription had an increased risk of food allergy.
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