Large-scale health insurance study showed that antibiotic use in infancy was associated with an increase in atopic dermatitis.

Abstract

This retrospective large-scale study examined the association between prescribing antibiotics for infants and subsequent atopic dermatitis (AD). The data covered the period from 1January 2005 to 31 December 2014 and were extracted from a Japanese health insurance claims database. The exposure was being prescribed antibiotics at less than 12months of age and the outcome was a subsequent diagnosis of AD. The primary analysis method was multivariable Cox proportional hazard regression analysis. A sibling-matched analysis was also performed to adjust for shared familial and environmental confounders. This study comprised 85954 infants: 8654 (10.1%) who had received antibiotics and 77300 who had not. AD was diagnosed in 1183 (13.7%) and 10325 (13.4%) infants respectively. The exposed group was more likely to develop AD than the non-exposed group, but this association disappeared when we carried out the secondary, sibling-matched analysis of the two groups. Other risk factors for AD were macrolides, aminoglycosides, food allergies and histamine H1 receptor antagonists. Antibiotic use in infancy was associated with a subsequent increase in the incidence of AD. This association should be considered when prescribing antibiotics, but antibiotic use may not be a critical factor for the development of AD.