A number of studies have suggested that early life exposure to antibiotics may lead to an increased risk of subsequent eczema.
To conduct a systematic literature review on the association between antibiotic use antenatally or in the first year of life, and the development of eczema.
We completed a systematic review and meta-analysis of observational studies involving children or young adults aged 0-25 years, which 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 in early life. The pooled OR for the seventeen studies examining postnatal antibiotic exposure was 1.41 (95% confidence interval [CI] 1.30 to 1.53). The pooled OR for the ten longitudinal studies was 1.40 (1.19 to 1.64), compared to a pooled OR of 1.43 (1.36 to 1.51) for the seven cross-sectional studies. There was a significant dose-response association, suggesting a 7% risk increase in eczema risk for each additional antibiotic course received during the first year of life (pooled OR=1.07 [1.02-1.11]). Finally, the pooled OR for the four studies relating to antenatal exposure was 1.30 (0.86 to 1.95).
Exposure to antibiotics in the first year of life, but not prenatally, is more common in children with eczema.