Background and aims Empirical antibiotic therapy is common in the neonatal period but often discontinued due to the lack of evidence of bacterial infection. Early antibiotic exposure may disturb microbial colonisation and immune maturation and thus increase the risk of immune-mediated diseases in later life. We investigated the long-term immune effects of early antibiotic exposure in neonates with or without evidence of infection.
Methods Altogether 622 neonates from ongoing allergy prevention studies underwent skin prick testing at the age of 12 months. Exposure to antibiotics commenced during the first 72 h of life was categorised as follows: no exposure, brief empirical exposure (less than 5 days) or therapy for documented infection (≥5 days). Outcomes were analysed by logistic regression.
Results Brief neonatal antibiotic exposure was associated with lower risk of prick test positivity (Table 1). The effect remained statistically significant after adjusting for potential confounding factors (Table 2).
Conclusions Brief antibiotic exposure during the first days of life without concomitant infectious disease appears to impact immune development.