Abstract
BackgroundTo assess the relationship between any systemic antibiotic prescription within the first year of life and the presence of an ICD-9-CM diagnosis code for food allergy (FA).MethodsThis was a matched case–control study conducted using South Carolina Medicaid administrative data. FA cases born between 2007 and 2009 were matched to controls without FA on birth month/year, sex, race/ethnicity. Conditional logistic regression was used to model the adjusted odds ratio (aOR) of FA diagnosis. All models were adjusted for presence of asthma, wheeze, or atopic dermatitis.ResultsA total of 1504 cases and 5995 controls were identified. Receipt of an antibiotic prescription within the initial 12 months of life was associated with FA diagnosis in unadjusted and adjusted models (aOR 1.21; 95 % CI 1.06–1.39). Compared to children with no antibiotic prescriptions, a linear increase in the aOR was seen with increasing antibiotic prescriptions. Children receiving five or more (aOR 1.64; 95 % CI 1.31–2.05) antibiotic prescriptions were significantly associated with FA diagnosis. The strongest association was noted among recipients of cephalosporin and sulfonamide antibiotics in both unadjusted and adjusted models.ConclusionsReceipt of antibiotic prescription in the first year of life is associated with FA diagnosis code in young children after controlling for common covariates. Multiple antibiotic prescriptions are more strongly associated with increases in the odds of FA diagnosis.
Highlights
To assess the relationship between any systemic antibiotic prescription within the first year of life and the presence of an ICD-9-CM diagnosis code for food allergy (FA)
Association of antibiotic prescription and Food allergy diagnosis Receipt of an antibiotic prescription within the initial 12 months of life was associated with FA diagnosis in unadjusted models (Table 3)
Compared to children with no antibiotic prescriptions, a linear increase in the adjusted odds ratio (aOR) was seen with increasing antibiotic prescriptions
Summary
To assess the relationship between any systemic antibiotic prescription within the first year of life and the presence of an ICD-9-CM diagnosis code for food allergy (FA). From 1997 to 2007, the prevalence of reported food allergy increased 18 % among children under age 18 years [1]. Commensal bacteria have been shown to protect against food allergen sensitization in mice [5] Attempts to translate these findings to early infancy in one study revealed that infants with low gut microbiota richness and elevated proportion of Enterobacteriaceae relative to Bacteroides spp. were associated with subsequent food allergen sensitization at 1 year of age [6]. We sought to explore the association between antibiotic prescription in the first year of life and the presence of any food allergy diagnosis code in young children
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