ANTIBIOTIC use in early life has been associated with an increased risk of atopic dermatitis (AD), likely due to gut microbiome disruption. AD is a common chronic inflammatory skin disease influenced by genetic and environmental factors.
The study utilised data from the Canadian CHILD birth cohort, which tracked 3,455 infants from birth to five years of age. The cohort included in this study had stool samples collected and comprehensive health and environmental exposure questionnaires administered at multiple intervals. The researchers analysed the relationship between early-life antibiotic use and AD development, focusing on gut microbiome changes. Specifically, species abundance at 1 year was compared.
Systemic antibiotic use in the first year of life was linked to a higher risk of AD (adjusted odds ratio [aOR]; 1.81, 95% confidence interval [CI]; 1.28-2.57, P<0.001), with this risk not significant for antibiotics used after the first year. A dose-response relationship was observed: one antibiotic course increased the risk (aOR; 1.67, 95% CI; 1.17-2.38), and two or more courses further increased the risk (aOR; 2.16, 95% CI; 1.30-3.59). When comparing species abundance in stool samples at 1 year, 18 species of the 72 tested were significantly altered in those with AD, and 15 were altered by antibiotic exposure. Of these, four overlapping species were significantly altered in those with early antibiotic exposure and AD: Bifidobacterium bifidum, Bifidobacterium longum, Eubacterium rectale, andTyzzerella nexilis.
Early antibiotic use disrupts gut microbiota, increasing the risk of AD, a condition that can precede other allergic diseases like asthma and food allergies. The findings emphasise careful antibiotic use in infancy to avoid long-term health impacts. The study suggests that stool microbiome analysis at one year could predict and enable early interventions for high-risk children. Despite the robust dataset, the cohort may not represent the general Canadian population due to potential biases such as urban and higher-income families and a maternal history of atopy.
Reference
Hoskinson C et al. Antibiotics taken within the first year of life are linked to infant gut microbiome disruption and elevated atopic dermatitis risk. J Allergy Clin Immunol. 2024; DOI:10.1016/j.jaci.2024.03.025.
