(SDAS) Antibiotics Received in the First Year of Life and Odds of Food Allergy in Children
Grantee: South Carolina Research Foundation
Principal Investigator: Bryan Love
Project Number: R40MC23628
Project Date: 04/01/2012
Age group(s)
- Early Childhood (3-5 years)
Abstract
In the US, food allergies are most prevalent during the first years of life and affect between 4- 8% of children. The overall prevalence has increased by nearly 20% from 1997 to 2000 with similar increases in physician visits and hospitalizations. The gastrointestinal tract plays an important role in immune function and tolerance to food. The intestinal immune system is able to distinguish between harmless proteins or commensal organisms and potentially harmful pathogens. This complex process is sometimes referred to as the gastrointestinal mucosal barrier. Developmental immaturity of this barrier in young children likely plays a role in the increased prevalence of food allergy during the first years of life. Infections are frequently encountered during childhood, and antibiotic prescriptions account for nearly one-third of all prescriptions in pre-school children. Systemic antibiotics are nonselective killers of susceptible bacteria and affect sites that are distant from the source of infection. Antibiotics with broader spectrum of activity (i.e. cephalosporins) would be more likely to kill multiple different species of microbes than narrow spectrum agents (i.e. penicillin). Antibiotics are known to affect the GI flora, with the potential to cause antibiotic-induced diarrhea or Clostridium difficile associated disease. We hypothesize that antibiotic exposure alters the gastrointestinal flora during a critical period when new foods (potential allergens) are being introduced into the diet of infants. Unhealthy or altered gastrointestinal flora interferes with normal immunoregulation and in the presence of new foods can lead to food allergy. We propose a case-control study design to investigate the association between antibiotic exposure and development of food allergy. We will select 1200 cases and 4800 controls from children enrolled in the South Carolina Medicaid program in 2010 and born between January 2007 and December 2009. We will utilize logistic regression to model the odds of food allergy by receipt of any antibiotic, by number of antibiotics received, and by type of antibiotic. The proposed study is submitted in response to Strategic Research Issue #IV: Promoting the healthy development of MCH populations, and to the MCHB Strategic Plan Goal 2: Promote an environment that supports maternal and child health. If early antibiotic exposure Increases the risk of food allergy in children and antibiotics are often utilized inappropriately (i.e. for viral infections), then additional efforts to reduce antibiotic utilization may reduce the overall incidence of food allergies in young children. In cases where antibiotic utilization is unavoidable (i.e. pneumonia), administration of probiotics may have the potential to reduce the development of food allergies. The national significance of the research is demonstrated by the frequency of antibiotic prescriptions in children, the prevalence of food allergy, and the significant impact of food allergy on quality of life and in some cases long term morbidity and mortality.Publications
Listed is descending order by year published.
Love BL, Mann JR, Hardin JW, Lu ZK, Cox C, Amrol DJ. Antibiotic prescription and food allergy in young children. Allergy Asthma Clin Immunol. 2016 Aug 17;12:41. doi: 10.1186/s13223-016-0148-7. PubMed PMID: 27536320; PubMed Central PMCID: PMC4988015.
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