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Children with early antibiotic exposure more likely to develop eczema

Children with eczema were more likely to have had exposure to antibiotics in the first year of life, according to study results.

Researchers conducted a systematic literature review and meta-analysis of Medline, Embase and Web of Science from inception until March 2012 of observational studies involving children and young adults aged 0 to 25 years, which assessed eczema risk and the impact of antibiotic exposure either in utero or during the first 12 months of life.

The association between prenatal and/or postnatal exposure to antibiotics and developing eczema in early life was examined in 20 studies (16 studies, postnatal exposure; three studies, prenatal exposure; one study, both prenatal and postnatal).

All studies examining postnatal antibiotic exposure had a pooled odds ratio of 1.41 (95% CI, 1.30-1.53). Of those studies, 10 were longitudinal and had a pooled OR of 1.40 (95% CI, 1.19-1.64), while seven were cross-sectional and had a pooled OR of 1.43 (95% CI, 1.36-1.51).

For every additional antibiotic course received during a child’s first year, risk for eczema increased by 7% (pooled OR=1.07; 95% CI, 1.02-1.11).

The prenatal exposures indicated a pooled OR of 1.30 (95% CI, 0.86-1.95).

“Overall, we found a significant positive association between postnatal antibiotic prescribing and eczema risk, which was equally strong for cross-sectional compared to longitudinal studies,” the researchers reported. “A similar pattern was evident for prenatal antibiotic exposure.

“Antibiotic exposure in early life may increase the risk of subsequent eczema by up to 40%, with broad-spectrum antibiotics having a more pronounced effect. Antibiotics should be prescribed with caution, especially in high-risk children.”