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Antacids, Antibiotics Exposure in Infancy Found to Induce Allergies

New study proposes infants exposed to antacids and antibiotics are to develop childhood allergies later on attributable to altered immune system pathways.

These medications are given frequently. In our study, we found that about 8% of all children received a prescription for acid-suppressive therapy,” said Dr. Edward Mitre, an associate professor in the Department of Microbiology and Immunology at the Uniformed Services University in Bethesda, Maryland, who was lead author of the study.

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Researchers combed the health records of kids born between 2001 and 2013 and covered by Tricare, an insurance program for active duty and retired military personnel and their families. A surprising 9 percent of the babies received antacids, reflecting the popularity of treating reflux in infancy.

Over four years, more than half of all the children developed allergies to foods or medications, rashes, asthma, hay fever or other allergic diseases. The study couldn’t prove causes, but the connection with antacids and antibiotics was striking.

Acid-suppressive medications are typically prescribed or available over the counter to help reduce problems related to gastric acidity, like acid reflux or ulcers, and commonly known versions of these drugs incude ranitidine and lansoprazole.

These medications are usually given to infants who regurgitate food and appear fussy. For most infants, though, regurgitation of food is not a disease. Rather, it’s a developmentally normal process,” Mitre said.

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There are some infants with severe gastroesophageal reflux, who have disease from this and who warrant medical therapy, but it is probable that the vast majority do not,” he said. “So we feel this study is important because it suggests that antibiotics and acid-suppressive medications should be used only in situations of clear clinical benefit, since we see this association with increased risk of allergies.”

Our microbiome affects how we digest foods, stay at a healthy weight, fight infection, and stave off diseases like diabetes. Through its link to our immune system, our microbiome is thought to be linked to our risk of allergic reactions.

Now these two common medications can mess up our microbiome. Antibiotics do it by killing not just the bacteria that make us sick, but also the bacteria that help keep us healthy. As for antacids, by making the stomach less acidic they make it more likely that bacteria from the mouth (that are normally killed by the acid in the stomach when swallowed) make it down into the intestine.

The team found that children who received an antacid during their first six months had double the chance of developing a food allergy; the chances of developing a severe allergic reaction called anaphylaxis or hay fever were about 50 percent higher.

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For those that received antibiotics, the chances doubled for asthma and were at least 50 percent higher for hay fever and anaphylaxis.

The study findings underscore well-known risks of antibiotics and counter the belief that acid-suppressives are harmless, Mitre said.

Given the association we and others have found between acid-suppressive medications and allergy, and given that they are not generally beneficial for infants, this study suggests that antibiotics and acid-suppressive medications should only be used in situations of clear clinical benefit,” Mitre concluded.

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