Large-scale health insurance study showed that antibiotic use in infancy was associated with an increase in atopic dermatitis

Acta Paediatr. 2022 Mar;111(3):607-613. doi: 10.1111/apa.16221. Epub 2021 Dec 27.


Aim: This retrospective large-scale study examined the association between prescribing antibiotics for infants and subsequent atopic dermatitis (AD).

Methods: The data covered the period from 1 January 2005 to 31 December 2014 and were extracted from a Japanese health insurance claims database. The exposure was being prescribed antibiotics at less than 12 months of age and the outcome was a subsequent diagnosis of AD. The primary analysis method was multivariable Cox proportional hazard regression analysis. A sibling-matched analysis was also performed to adjust for shared familial and environmental confounders.

Results: This study comprised 85 954 infants: 8654 (10.1%) who had received antibiotics and 77 300 who had not. AD was diagnosed in 1183 (13.7%) and 10 325 (13.4%) infants respectively. The exposed group was more likely to develop AD than the non-exposed group, but this association disappeared when we carried out the secondary, sibling-matched analysis of the two groups. Other risk factors for AD were macrolides, aminoglycosides, food allergies and histamine H1 receptor antagonists.

Conclusion: Antibiotic use in infancy was associated with a subsequent increase in the incidence of AD. This association should be considered when prescribing antibiotics, but antibiotic use may not be a critical factor for the development of AD.

Keywords: anti-bacterial agents; atopic dermatitis; health insurance claims; infants; siblings.

MeSH terms

  • Anti-Bacterial Agents / adverse effects
  • Dermatitis, Atopic* / drug therapy
  • Dermatitis, Atopic* / epidemiology
  • Eczema*
  • Humans
  • Infant
  • Insurance, Health
  • Retrospective Studies
  • Risk Factors


  • Anti-Bacterial Agents