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Large-scale health insurance study showed that antibiotic use in infancy was associated with an increase in atopic
Tetsuya Tsuchida1, Satomi Yoshida1, Masato Takeuchi1
1Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
Insights
Infant antibiotic exposure showed an initial link to atopic dermatitis (AD), but this association vanished in sibling-matched analyses, suggesting antibiotics may not be a critical factor for AD development.
Area of Science:
- Pediatrics
- Dermatology
- Pharmacology
Background:
- Infant antibiotic exposure is a growing concern.
- The link between early antibiotic use and atopic dermatitis (AD) requires further investigation.
Purpose of the Study:
- To examine the association between antibiotic prescription in infancy and the subsequent development of atopic dermatitis (AD).
Main Methods:
- Retrospective analysis of a Japanese health insurance claims database (2005-2014).
- Involved over 85,000 infants, comparing antibiotic exposure in the first 12 months of life with subsequent AD diagnosis.
- Utilized multivariable Cox regression and sibling-matched analyses to control for confounders.
Main Results:
- Initial analysis indicated a higher likelihood of AD in infants prescribed antibiotics.
- However, a sibling-matched analysis found no significant association between infant antibiotic use and AD.
- Identified macrolides, aminoglycosides, food allergies, and H1 antagonists as other risk factors for AD.
Conclusions:
- While an initial association was observed, infant antibiotic use may not be a critical factor in the development of atopic dermatitis.
- Prescribing decisions for infant antibiotics should consider potential associations, but causality is not established by this study.
Aim:
This retrospective large-scale study examined the association between prescribing antibiotics for infants and subsequent atopic dermatitis (AD).
Methods:
The data covered the period from 1 January 2005 to 31 December 2014 and were extracted from a Japanese health insurance claims database. The exposure was being prescribed antibiotics at less than 12 months of age and the outcome was a subsequent diagnosis of AD. The primary analysis method was multivariable Cox proportional hazard regression analysis. A sibling-matched analysis was also performed to adjust for shared familial and environmental confounders.
Results:
This study comprised 85 954 infants: 8654 (10.1%) who had received antibiotics and 77 300 who had not. AD was diagnosed in 1183 (13.7%) and 10 325 (13.4%) infants respectively. The exposed group was more likely to develop AD than the non-exposed group, but this association disappeared when we carried out the secondary, sibling-matched analysis of the two groups. Other risk factors for AD were macrolides, aminoglycosides, food allergies and histamine H1 receptor antagonists.
Conclusion:
Antibiotic use in infancy was associated with a subsequent increase in the incidence of AD. This association should be considered when prescribing antibiotics, but antibiotic use may not be a critical factor for the development of AD.
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