260 Use of antibiotics in preschool age predicts atopic and allergic skin diseases in adolescents: A retrospective cohort study

Abstract

The prevalence of atopic and allergic skin diseases has increased rapidly worldwide; and the overuse of antibiotics in the treatment of upper respiratory infection (URI) has been observed in China. The current study aimed to investigate the associations of antibiotics use in preschool age (<7 years old) with the atopic and allergic skin diseases in adolescents in China. A retrospective cohort study was conducted in a group of newly-enrolled college students in five universities in different regions of China. The frequency of URI and the use of antibiotics in preschool age was inquired through the questionnaire survey. Skin diseases were diagnosed by dermatologists during the health examination. Study outcomes included: 1) atopic dermatitis; 2) hand eczema; 3) allergic skin diseases (chronic urticaria, allergic contact dermatitis, photoallergic reactions); and 4) atopic march (asthma, atopic dermatitis, allergic rhinitis). Two-level logistic models were used to estimate the associations, and adjusted relative risks (ARRs) were presented as the effect size. A total of 20138 participants were analyzed. The mean age was 18.0 ± 0.8, and 50.7% of the participants was male. The use of antibiotics in preschool age (rare, reference group; occasionally; often, administered orally; often, administered i.v.) was significantly associated with atopic dermatitis (ARR: 0.89, 1.10, 1.30; P=0.004), hand eczema (ARR: 0.86, 1.14, 1.10; P=0.043), allergic skin diseases (ARR: 1.09, 1.24, 1.37; P=0.026), and atopic march (ARR: 1.11, 1.43, 1.66; P<0.001), in a dose-response manner, after adjustments for demographic variables (age, gender, ethnicity, and family income). Interactions between the frequency of URI and use of antibiotics was also tested, and the results were consistent. Use of antibiotics in the treatment of URI in preschool age is associated with atopic and allergic skin diseases in adolescents.