Systemic antibiotic exposure in the first year of life has been linked to a higher risk of atopic dermatitis (AD) in a dose-response manner, as reported in a recent study published in the Journal of Allergy and Clinical Immunology. Researchers from the University of British Columbia in Vancouver, Canada, led by Courtney Hoskinson, investigated the relationship between systemic antibiotic use (oral or intravenous), the gut microbiome, and AD.
The study revealed that the administration of systemic antibiotics during the first year of life, compared to later periods, was associated with an increased risk of AD (adjusted odds ratio of 1.81). Moreover, the risk of developing AD increased with the number of antibiotic courses taken, with adjusted odds ratios of 1.67 and 2.16 for one course and two or more courses, respectively. The alterations in the gut microbiome, which are linked to both AD and systemic antibiotic use, were found to fully mediate the impact of antibiotic use on AD development.
Among infants who later developed AD, changes in the one-year gut microbiome included elevated levels of Tyzzerella nexilis, heightened monosaccharide utilization, and reduced levels of Bifidobacterium, Eubacterium spp., and fermentative pathways. The authors suggest that the modulation of key gut microbiome components due to early-life antibiotic use, particularly in the first year, could serve as markers for predicting and potentially preventing AD development.
This study underscores the importance of considering the implications of systemic antibiotic use in infancy on the risk of developing atopic dermatitis. By understanding the interplay between antibiotics, the gut microbiome, and AD, healthcare professionals may be better equipped to address and potentially mitigate the onset of this common skin condition.
