Wheezing and infantile colic are associated with neonatal antibiotic treatment

Pediatr Allergy Immunol. 2018 Mar;29(2):151-158. doi: 10.1111/pai.12857. Epub 2018 Feb 7.


Background: Cohort 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.

Methods: The INCA study is a prospective observational birth cohort study of 436 term infants, with follow-up of 1 year; 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 1 year, doctors' diagnoses were registered and a blood sample was taken (n = 205).

Results: Incidence 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-.

Conclusion: Antibiotic 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.

Keywords: antibiotics; atopy; eczema; infant; infantile colic; neonate; sensitization; wheezing.

Publication types

  • Observational Study

MeSH terms

  • Anti-Bacterial Agents / adverse effects*
  • Cohort Studies
  • Colic / chemically induced*
  • Colic / epidemiology
  • Female
  • Humans
  • Hypersensitivity / epidemiology
  • Hypersensitivity / etiology*
  • Immunization
  • Immunoglobulin E / blood
  • Incidence
  • Infant, Newborn
  • Male
  • Prospective Studies
  • Respiratory Sounds / etiology*
  • Risk Factors


  • Anti-Bacterial Agents
  • Immunoglobulin E