Wheezing and infantile colic are associated with neonatal antibiotic treatment

BackgroundCohort studies have suggested that early-life antibiotic treatment is associated with increased risk of atopy. We determined whether antibiotic treatment already in the first week of life increases the risk of atopic and non-atopic disorders. MethodsThe INCA study is a prospective observational birth cohort study of 436 term infants, with follow-up of 1year; 151 neonates received broad-spectrum antibiotics for suspected neonatal infection (AB+), vs a healthy untreated control group (N=285; AB-). In the first year, parents recorded daily (non-) allergic symptoms. At 1year, doctors' diagnoses were registered and a blood sample was taken (n=205). ResultsIncidence of wheezing in the first year was higher in AB+ than AB- (41.0% vs 30.5%, P=.026; aOR 1.56 [95%CI 0.99-2.46, P=.06]). Infantile colics were more prevalent in AB+ compared to AB- (21.9% and 14.4% P=.048), and antibiotic treatment was an independent risk factor for infantile colics (aOR 1.66 (95%CI 1.00-2.77) P=.05). Allergic sensitization (Phadiatop >0.70kUA/L) showed a trend toward a higher risk in AB+ (aOR 3.26 (95%CI 0.95-11.13) P=.06). Incidence of eczema, infections, and GP visits in the first year were similar in AB+ and AB-. ConclusionAntibiotic treatment in the first week of life is associated with an increased risk of wheezing and infantile colics. This study may provide a rationale for early cessation of antibiotics in neonates without proven or probable infection.