This systematic review and meta-analysis of observational studies, involving children or young adults aged 0-25 years, 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 subsequent development of eczema.
The pooled OR for the 17 studies examining postnatal antibiotic exposure was 1.41 (95% CI 1.30-1.53). The pooled OR for the 10 longitudinal studies was 1.40 (95% CI 1.19-1.64), compared with a pooled OR of 1.43 (95% CI 1.36-1.51) for the seven cross-sectional studies.
There was a significant dose-response association, suggesting a 7% increase in the risk of eczema for each additional antibiotic course received during the first year of life; the pooled OR was 1.07 (95% CI 1.02-1.11).
Finally, the pooled OR for the four studies relating to antenatal exposure was 1.30 (95% CI 0.86-1.95).
The authors conclude that exposure to antibiotics in the first year of life, but not prenatally, is more common in children with eczema.
Tsakok T, McKeever T, Yeo L et al. Br J Dermatol 2013; 169: 983-91