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A study of nearly 800,000 children found that infants who were given antibiotics had an increased risk of developing allergies (such as food allergies), asthma or dermatitis as children. A causative relationship was not found and more research is needed to determine the nature of the association. 32 August 2020 Inhalation Back Page Antibiotics commonly prescribed to infants may lead to an increased risk of allergies later in childhood, according to a study published in JAMA Pediatrics and reported by CNN. e study found that infants who were given antibiot- ics—penicillin, cephalosporin, sul- fonamide or macrolide—had an increased risk of developing aller- gies (such as food allergies), asthma or dermatitis as children. Records examined for nearly 800,000 children e study analyzed medical records of 798,426 children born between 2001 and 2013, who were beneficiaries of the United States Department of Defense TRICARE program, a healthcare program for uniformed service members, retirees and their fam- ilies around the world. e researchers determined which children had been given prescrip- tions for penicillin, penicillin with B-lactamase inhibitor, cephalo- sporin, sulfonamide or macrolide within the first six months of life. ey also examined which chil- dren were later diagnosed with an allergy such as food allergy, ana- phylaxis, asthma, atopic dermati- tis, allergic rhinitis, allergic con- junctivitis or contact dermatitis. Risk with multiple antibiotic classes Results showed that the antibiotics researchers studied were associated with increased risks for a subse- quent diagnosis of allergic disease. e risk was lowest for sulfon- amides and highest for penicillin. "Being prescribed an antibiotic increased the risk of later devel- opment of allergic disease any- where from 8% for food allergy to 47% for the development of asthma," explained Dr. Cade Nylund, a pediatrician and pedi- atric gastroenterologist at the Uniformed Services University in Maryland, US, who was one of the study authors. "We have demonstrated that not only are antibiotics associated with an increased risk of aller- gic disease but that there is an increased risk associated with the prescription of multiple classes of antibiotics," said Nylund. "I was surprised to see an association of all classes of antibiotics with the later development of allergic dis- ease," he noted. Correlation but not causation Importantly, the study found a correlation—but not causation— between infant antibiotic use and development of allergies. More research is needed to determine the nature of the association that was found. According to the research paper, it is possible the medications can affect an infant's gut bacte- ria, CNN reported. In addition, the CNN article indicated that infants at increased risk of devel- oping allergic disease also may be more susceptible to bacterial infections requiring antibiotics. Perspectives for parents CNN also obtained comments from Dr. Purvi Parikh, an allergist and immunologist at NYU Lan- gone Health in New York and a spokesperson for the Allergy and Use of antibiotics in infants correlates with allergies in children, though causation not shown