Antibiotics in Early Life and Allergic Disorders

To the Editor We read with interest the Mitre et al article describing associations between acid-suppressive medications, antibiotics, and subsequent pediatric allergic disease. Because histamine-2-receptor antagonists (H2RAs) are commonly prescribed for children with gastroesophageal reflux disease (GERD), the authors presented analyses of associations between H2RAs and allergic diseases, including food allergy, for all children, and only those dwho received a diagnosis of GERD. However, compared with any food allergy or individual foods among children given H2RAs, milk allergy has both a higher incidence and higher hazards ratios, which may partially drive the strong association between H2RAs and “any food allergy.” Infants with milk allergy often tolerate milk by early childhood, an observation that the authors did not consider herein. Because the ability to consider tolerance may not have been possible in a health care database study, an analysis excluding children with only milk aller gy would have been interesting. Similarly, we would have liked to have seen results for individual food allergies among the children with GERD.
Source: JAMA Pediatrics - Category: Pediatrics Source Type: research