The British Journal of Dermatology
Does Early Life Exposure to Antibiotics Increase the Risk of Eczema? A Systematic Review
Br J Dermatol 2013 Nov 01;169(5)983-91, T Tsakok, TM McKeever, L Yeo, C Flohr
A number of studies have suggested that early life exposure to antibiotics can lead to an increased risk of developing eczema. This systematic review and meta-analysis of observational studies, involving children or young adults aged 0-25 years, assessed the impact of antibiotic exposure either in utero or during the first 12 months of life on subsequent eczema risk. Twenty studies examined the association between prenatal and/or postnatal exposure to antibiotics and development of eczema. The pooled odds ratio (OR) for the 17 studies examining postnatal antibiotic exposure was 1·41 [95% confidence interval (CI) 1·30-1·53]. The pooled OR for the 10 longitudinal studies was 1·40 (95% CI 1·19-1·64), compared with a pooled OR of 1·43 (95% CI 1·36-1·51) for the seven cross-sectional studies. There was a significant dose-response association, suggesting a 7% increase in the risk of eczema for each additional antibiotic course received during the first year of life [pooled OR 1·07 (95% CI 1·02-1·11)]. Finally, the pooled OR for the four studies relating to antenatal exposure was 1·30 (95% CI 0·86-1·95). We conclude that exposure to antibiotics in the first year of life, but not prenatally, is more common in children with eczema.