Early exposure to antibiotics and infections and the incidence of atopic eczema: a population-based cohort study

This study describes the complex relationship between early exposure to infections, anti-infectious treatment with antibiotics, and incident AE. Using a German population-based administrative healthcare and prescription database, a cohort of 370 children not diagnosed as having AE during their first year of life was established. For each individual child all infections and prescriptions of antibiotics within the first year as well as incident AE within the second year of life were identified. Crude analyses suggested that early infections and exposure to antibiotics are risk factors for AE. However, stratified analyses indicated that early infections were only associated with a higher rate of AE when treated with broad-spectrum antibiotics such as cephalosporines or macrolides. The results for other common childhood infections tended to be similar. Antibiotic treatment appears to modify the association between early infections and subsequent AE. The study found no evidence that infections per se significantly alter the likelihood for subsequent AE. Pediatr Allergy Immunol. 2010;21(2 Pt 1):292-300. Epub 2009 Aug 27.