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Published on: September 27, 2017
Early-life exposure to antibiotics and subsequent development of atopic dermatitis
Anna Cantarutti1,2, Claudio Barbiellini Amidei3, Andrea Stella Bonaugurio2
1National Centre for Healthcare Research and Pharmacoepidemiology, Department of Statistics and, Quantitative Methods, University of Milano-Bicocca, Milan, Italy.
Insights
Early antibiotic exposure in children is not linked to a higher risk of developing atopic dermatitis (AD). Further analysis suggests potential protopathic bias, not a true association between antibiotics and AD onset.
Area of Science:
- Pediatrics
- Dermatology
- Epidemiology
Background:
- Antibiotic use in early childhood is a growing concern.
- Potential links between antibiotic exposure and atopic dermatitis (AD) require thorough investigation.
Purpose of the Study:
- To assess the association between early-life antibiotic exposure and the subsequent risk of developing atopic dermatitis (AD) in children.
Main Methods:
- A cohort study utilizing the Italian Pedianet database (2004-2017).
- Cox proportional-hazards models were employed to analyze data from 73,816 children.
- Antibiotic exposure during the first year of life was examined as both a fixed and time-varying variable.
Main Results:
- Early antibiotic exposure showed no significant association with incident atopic dermatitis (AD) (HR: 1.02, 95% CI: 0.97-1.07).
- No dose-response relationship was observed between antibiotic exposure and AD risk.
- Time-varying analysis indicated a temporary association, which diminished with time-lag analysis, suggesting protopathic bias.
Conclusions:
- The study does not support a significant association between early antibiotic exposure and the onset of atopic dermatitis (AD).
- Findings suggest that observed associations may be influenced by protopathic bias, where symptoms of the condition lead to early treatment.
Background:
Antibiotic exposure may be associated with atopic dermatitis (AD). We assessed the risk of developing AD among children early exposed to antibiotics.
Research Design And Methods:
From the Italian Pedianet database, children aged 0-14 years between 2004-2017 were enrolled from birth up to at least one year. Cox proportional-hazards models were fitted to estimate Hazard Ratios (HR) and 95% Confidence Intervals (CI) for the association between antibiotic exposure during the first year of life with incident AD. Exposure was also considered as a time-varying variable.
Results:
73,816 children were included in the final cohort, of which 34,202 had at least one antibiotic prescription. Incident AD was present in 8% of unexposed and exposed children. Early antibiotic exposure was not associated with any excess risk of AD compared to unexposed children (HR: 1.02, 95% CI: 0.97-1.07), and no dose-response effect was observed. In the time-varying analysis, antibiotic exposure was significantly associated with AD onset (1.12, 1.07-1.17). However, when taking into account the time-lag between exposure and outcome, risks progressively decreased, suggesting possible protopathic bias.
Conclusion:
These results are not suggestive of any significant association between exposure to antibiotics and subsequent AD onset and support the possible presence of protopathic bias.
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