No Class-Specific Early-Life Antibiotics Linked to Allergy, With Moath Hattab, MD

In a multicenter retrospective cohort of 423 children exposed to antibiotics in the first 6 months of life, nearly one-third (29.6%) were reported to have developed allergic disease in later childhood, with no clear association by antibiotic class or number of classes used.1

“The absence of a class specific signal suggests that within antibiotic exposed infants, they couldn't identify one common antibiotic class that consistently increased or decreased later allergy risk, which is consistent with most previous studies, indicating no less specific association, but a general association between antibiotics and allergy,” lead investigator Moath Hattab, MD, from An-Najah National University, told HCPLive.

The analysis revisits a longstanding clinical concern: whether early microbiome disruption meaningfully alters allergic risk trajectories. Another study published this year showed that early-life gut bacteria were linked to a lower food allergy risk and identified the strongest drivers of colonization with allergy-protective gut bacteria in infancy, which included vaginal delivery, exclusive breastfeeding, and early exposure to siblings.2

Hattab and colleagues hypothesized that antibiotic use in infants would alter the microbiota and, as a result, would increase allergy risk.1 The study, conducted across 3 hospitals in the West Bank, Palestine, from April 2024 to January 2025, included 423 children (mean age, 7.33 years; 62.41% males) who had received antibiotic treatment within the first 6 months of life. The most frequently prescribed antibiotics were Beta-lactams: cefotaxime (78.49%) and ampicillin (63.59%).

Early-life antibiotics led to allergies in 29.55% of the sample. The most common manifestations of allergies included skin reactions (70.4%), wheezing (16.8%), and respiratory symptoms (10.4%); frequent triggers were food (10.17%) and dust (7.33%). The team observed a significant decrease in allergy with increasing age (P =.011).

The study identified no significant link between the number of antibiotics used and the development of allergies (P =.45). The analysis also did not show an association between the class of antibiotics and allergy development, except for Trimethoprim/Sulfamethoxazole (P =.05).

“We saw a small signal suggesting lower allergy odds with trimethoprim/sulfamethoxazole as well,” Hattab said. “Because this exposure was uncommon, and the study is observational, it's not practice-changing. It's best viewed as a research signal to test a larger prospective data set.”

References

1. Hattab M, Sarrees YA, Sous M, et al. Early-life antibiotics and childhood allergy: a multi-center cohort. Allergy Asthma Clin Immunol. Published online February 3, 2026. doi:10.1186/s13223-026-01013-5

2. Pedersen S. HCPLive. Early-Life Gut Bacteria Linked to Lower Food Allergy Risk, With Susanne Pedersen. Published on February 5, 2026. Accessed on February 13, 2026. https://www.hcplive.com/view/early-life-gut-bacteria-linked-lower-food-allergy-risk-susanne-pedersen