Antibiotic Use in early infancy Linked to Increased Risk of Atopic Dermatitis, claims study

Atopic dermatitis (AD) is a common chronic inflammatory skin disease that affects both children and adults, often driven by genetic and environmental factors. Early exposure to antibiotics is believed to disrupt the gut microbiome, which can influence the development of allergic conditions such as AD.

The study involved a longitudinal analysis of data from the Canadian CHILD birth cohort, which tracked infants from birth to 5 years of age and beyond. The cohort included 3,455 eligible infants with no congenital abnormalities who were born at a minimum of 34 weeks of gestation.

The researchers examined the association between antibiotic use in the first year of life and the development of AD by the age of 5 years. They collected stool samples from a subset of infants and analyzed microbial features sensitive to antibiotic exposure.

The key findings of the study were:

• Use of systemic antibiotics during the first year of life was associated with an increased risk of AD (adjusted OR 1.81, 95% CI 1.28-2.57, P<0.001).

• The risk was not significant when antibiotics were used after 1 year of age.

• A dose-response-like relationship was observed between the number of antibiotic courses and the increased risk of AD (one course: aOR 1.67, 95% CI 1.17-2.38; two or more courses: aOR 2.16, 95% CI 1.30-3.59).

• The study found that 18 species of 72 tested were significantly altered in those with AD, while 15 species were altered by antibiotic exposure.

• Four overlapping species were significantly altered in patients with both antibiotic exposure during the first year of life and AD at 5 years: Bifidobacterium bifidum (mean relative abundance 5.03%), Bifidobacterium longum (14.87%), Eubacterium rectale (1.17%), and Tyzzerella nexilis (0.20%).

The study suggests that early-life exposure to antibiotics may disrupt the gut microbiome, potentially leading to the development of AD. This underscores the importance of cautious antibiotic use in infancy.

Early antibiotic use is linked to an increased risk of atopic dermatitis, emphasizing the need for careful consideration of antibiotic prescriptions in infancy. Stool microbiome analysis may provide insights into predicting and managing the risk of AD and other allergic conditions in children.

Reference:

Hoskinson, C., Medeleanu, M. V., Reyna, M. E., Dai, D. L. Y., Chowdhury, B., Moraes, T. J., Mandhane, P. J., Simons, E., Kozyrskyj, A. L., Azad, M. B., Petersen, C., Turvey, S. E., & Subbarao, P. (2024). Antibiotics within first year are linked to infant gut microbiome disruption and elevated atopic dermatitis risk. The Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2024.03.025