The use of antibiotics and acid suppressor medications can cause changes the gut flora. Changes in the microbes can increase the risk of allergic diseases. A recent study looked into the use of antibiotics or acid suppressive medications. Histamine 2 receptor antagonists, i.e. Zantac (ranitidine) or proton pump inhibitors, Prilosec (omeprazole), within the first 6 months of life and whether or not it predisposed to later development of allergic disease.
Allergic disease was defined as the presence of food allergy, atopic dermatitis (eczema), asthma, anaphylaxis, allergic rhinitis, urticaria, contact dermatitis, medication allergy or any other form of allergy.
Of the nearly 800,000 children
- 8% were prescribed an acid blocker
- 1.7% were prescribed a proton pump inhibitor
- 16.6% were prescribed an antibiotic during the first 6 months of life.
Increased risk of every allergic disease category was observed with all medications and the highest risk were for the acid blocking medications compared with antibiotics. The risk was deemed substantial.
Food allergy had the highest association with Zantac and Prilosec classes of medications.
Asthma had the highest association with antibiotic usage.
The authors concluded that the use of acid suppressive medications or antibiotics might predispose to development of allergic diseases in early childhood.
The lead author in the study, Dr. Mitre wrote, “Antacid medications are considered generally harmless and something to try with fussy babies who spit up a lot. Our results, in conjunction with those of other animal and human studies, suggest we should be more cautious prescribing these medicines in infants.”
We have written extensively about how the gut environment can play a role in allergies.
This is the first time we have mentioned that these acid blocker medication may play a role in promoting allergies in children, notably food allergies in this case.
Common H2 blockers are:
- nizatidine (Axid)
- famotidine (Pepcid, Pepcid AC)
- cimetidine (Tagamet, Tagamet HB)
- ranitidine (Zantac)
Proton Pump Inhibitors are:
- Ilaprazole (not FDA-approved as of May 2017)
Further commenting about the antibiotic risk, Dr. Yudy Persaud, Chief Division of Allergy at the prestigious BronxCare Networks, states “We evaluated over 12,000 charts among pregnant mothers and found that if you had an infection during the first 2 trimester of pregnancy that there was a significant association with atopic diseases. These includes asthma and eczema in children. This relationship was also seen with the use of antibiotics, although it did not matter what type of antibiotics was used”