Wheezing and infantile colic are associated with neonatal antibiotic treatment

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.