Antibiotic Exposure Linked to Higher Risk of Childhood Atopic Dermatitis: Study
According to a recent meta-analysis published in eClinicalMedicine, antibiotic use during pregnancy or in early childhood significantly increases the risk of developing atopic dermatitis (AD) in children. The study analyzed 39 cohort studies involving pregnant women and children under 5, highlighting a strong association between early antibiotic exposure and this chronic inflammatory skin condition. The study was conducted by Huawei Zhao and colleagues.
Atopic dermatitis occurs in about 2% of adults but is seen in as many as 4% of children, making it a significant atopic condition in children. Antibiotics, one of the most frequently prescribed medications in early life, are frequently used in the first years of life or even prenatally. This broad exposure has raised questions about its effect on immune system development, gut microbiota, and the potential for the development of allergic conditions such as eczema. Although previous studies implied a connection, conclusive results have been out of reach until this latest research.
To examine the possible relationship between antibiotic use and AD in children, researchers undertook a systematic review and meta-analysis. The research examined 39 articles in both English (Scopus, PubMed, Web of Science, Cochrane Library) and Chinese (VIP, CNKI, Wanfang) databases, until the data cut date of May 1, 2025. A random-effects model meta-analysis was utilized to evaluate aggregated data. The review covered 7,487,925 children, making the study one of the largest of its nature. Registration for the study in the PROSPERO database (CRD42024535141) was done.
Key Findings
Overall Risk: Children exposed to antibiotics at the time of pregnancy or early life had a 22% higher risk of acquiring AD (OR = 1.22, 95% CI: 1.17–1.28) with high heterogeneity (I² = 98.06%).
Timing of Exposure: Children exposed post-birth were at greater risk of eczema than those exposed during pregnancy.
Influencing Factors: AD risk differed according to:
Diagnostic criteria employed for AD.
Race of the child.
Type and frequency of antibiotic exposure.
Age at measurement of outcome (but not age at exposure).
Geographic Location: Residence location did not influence the association between antibiotic use and AD risk significantly.
These findings reflect the need for cautious use of antibiotics in pregnant women and young children. The link between antibiotics and AD can be mediated by their actions on emerging immune responses and gut microbiota in those phases of early life that are particularly formative. Pediatricians and obstetricians will be required to review prescribing habits and consider very carefully the use of antibiotic therapy, particularly where there are alternative treatments available.
Reference:
Zhao, H., Luo, Y., Li, W., Jiang, C., Jin, E., & Xu, Z. (2025). Association between antibiotic exposure and childhood atopic dermatitis: a systematic review and meta-analysis. EClinicalMedicine, 84(103296), 103296. https://doi.org/10.1016/j.eclinm.2025.103296
