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April 17, 2013 at 2:14 PMComments: 0 Faves: 0

Study: Link Found Between Food Allergies and Antibiotic Use in Infants

By Jeffrey VanWingen M.D. More Blogs by This Author

Since the serendipitous discovery of penicillin in 1928, antibiotics have been saving lives. Like with many things, however, too much of a good thing can cause problems. Over recent years, we have seen problems with super-resistant bacteria caused by antibiotic overuse. Antibiotic-associated colitis cases have also risen dramatically due to increased use of more potent antibiotics. A recent study has brought to light perhaps another problem on the backhand of antibiotic use in infants: increased food allergy risk.

Antibiotic Use in Infants

Kids get sick a lot. It seems like they are always bringing something home every time they venture out into infection-laden outside world. When humans are born, they pretty much have two strikes against them. First, their immune system is immature and still developing for the first few months. Second, they come into the world with a clean slate, no experience against the hundreds of varieties of infectious microorganisms.

Breast feeding helps for the first six months, giving a child his mother's immune experience in the form of immunoglobulin found in breastmilk. Non-breastfed kids and six month olds are on their own, however.

Once we get many illnesses, our immune system gains experience at fighting the infection. Dues need to be paid. This is mostly true of viral infections. Bacterial infections, namely in the ears and respiratory tract, are also more common for which antibiotics are prescribed.

The Study

A recent presentation at the American Academy of Allergy, Asthma and Immunology annual meeting looked at food allergy and antibiotic experience in the first year of 7,500 subjects. 1,100 were case patients with some sort of food allergy. Of those with food allergies, an average of 2.7 antibiotic courses were given, compared to 1.8 in the control group. 24% had never received an antibiotic in the first year, compared with 33% in the controls. Increased numbers of antibiotic courses were associated with increased likelihood of developing allergy. Also, antibiotics in the later half of the first year was associated with increased risk. 

What Does This Mean?

A couple of items make a great deal of sense in the findings. First, normal gut bacteria in infants promote food tolerance. Babies are usually introduced to many new foods after six months of age. Throwing antibiotics into this mix that wipe out gut bacteria would logically increase risk of problems in this process. In breast-fed infants, the mothers' immune factors found in breast milk wane after six months. While these factors support an association, other issues must be considered. 

It stands to reason that infants who are prescribed more antibiotics are "sicker" and likely to get other afflictions. To help quell such bias, infants with asthma and eczema were excluded from the study due to a known association with allergy. Still, such association bias must be considered. Demographically, food allergies are on the rise, while, over the past few years, healthcare providers are becoming more judicious with antibiotic use.

These findings are intriguing and my feelings are mixed. While I would certainly not withhold needed antibiotics over concerns about allergy, it does deserve consideration.

A recent study raised suspicion that antibiotic use in infants during the first year of life may increase their risk to go on and develop food allergies. While no conclusions are solid at this point, it does raise concern.  As food allergies are a serious, potentially fatal, and increasing problem, it's clear that more investigation is needed to solidify and better understand an association. For now, judicious use of antibiotics is the modus operandi.

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