Certain Medications Prescribed to Newborns Increasing Allergic Diseases
Pharmacists fill them all the time -- prescriptions for acid-suppressing medications and/or antibiotics for infants in the first six months of life. Now, a new study finds that use of those drugs can raise the risk of later development of allergic diseases. How great is the risk?
BETHESDA, MD – How much is the increasing use of medications that alter the development of the human microbiome fueling the rise in allergic diseases?
That is one of the questions addressed in research published recently in JAMA Pediatrics. The article notes that both gastric acid–suppressive medications and antibiotics have been implicated as factors that may enhance the development of allergies.
Specifically, the study led by Uniformed Services University of the Health Sciences researchers determined that the use of acid-suppressing medications or antibiotics in the first six months of infancy was linked to a heightened of risk of development of allergic diseases later in childhood.
"Allergic diseases and asthma have been on the rise over several decades," study authors note. "Medications that can alter the human microbiome may contribute to the rise of allergic diseases. Acid-suppressing medicines and antibiotics can contribute to a microbial imbalance in the gut (intestinal dysbiosis)."
To reach those conclusions, the study team focused on 792,130 children born between October 2001 and September 2013 and enrolled in the military health system for at least their first year of life.
Factors considered in the observational study were any dispensed prescription for a histamine-2 receptor antagonist (H2RA), proton pump inhibitor (PPI) or antibiotic (exposures) in the first six months of life and diagnosis of allergic disease, defined as the presence of food allergy, anaphylaxis, asthma, atopic dermatitis, allergic rhinitis. allergic conjunctivitis, urticaria, contact dermatitis, medication allergy or other allergies.
Results indicate that the use of acid-suppressing medicines was associated with increased risks for all major categories of allergic disease, especially food allergy. The researchers also found that antibiotics also were associated with increased risk of all major categories for allergic disease.
Specifically, of 792 130 children included for analysis, 7.6% were prescribed an H2RA, 1.7% were prescribed a PPI, and 16.6% were prescribed an antibiotic during the first six months of life. The study reports that adjusted hazard ratios (aHRs) in children prescribed H2RAs and PPIs, respectively, were:
- 2.18 (95% CI, 2.04-2.33) and 2.59 (95% CI, 2.25-3.00) for food allergy,
- 1.70 (95% CI, 1.60-1.80) and 1.84 (95% CI, 1.56-2.17) for medication allergy,
- 1.51 (95% CI, 1.38-1.66) and 1.45 (95% CI, 1.22-1.73) for anaphylaxis,
- 1.50 (95% CI, 1.46-1.54) and 1.44 (95% CI, 1.36-1.52) for allergic rhinitis, and
- 1.25 (95% CI, 1.21-1.29) and 1.41 (95% CI, 1.31-1.52) for asthma.
As for antibiotic prescriptions in the first six months of life, aHRs were 2.09 (95% CI, 2.05-2.13) for asthma, 1.75 (95% CI, 1.72-1.78) for allergic rhinitis, 1.51 (95% CI, 1.38-1.66) for anaphylaxis, and 1.42 (95% CI, 1.34-1.50) for allergic conjunctivitis.
In light of their findings, study authors recommend, "Acid-suppressive medications and antibiotics should be used during infancy only in situations of clear clinical benefit."