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Acid-Suppressive Medication and Antimicrobial Use in Infancy Associated with Food Allergy and Anaphylaxis

AAAAI News Release

February 5, 2024

Candace Archie, Communications & Public Relations Manager
(414) 272-6071

New research shows infants exposed to acid-suppressive medication had nearly a 6-fold increased risk of food allergy

MILWAUKEE – Patients who were prescribed proton pump inhibitors (PPIs) in infancy demonstrated increased food allergy risk, according to new research being presented at the 2024 American Academy of Allergy, Asthma & Immunology Annual Meeting, in Washington, DC this month.

“Our study investigated the association between acid-suppressive medication or antimicrobial exposure during infancy and childhood allergic disease. We found that early exposure to acid-suppressive medications was associated with a 5-6 times higher risk of food allergy and anaphylaxis, with similar trends observed for antimicrobials,” said primary author Julia Tanzo while working with co-author Mohamad Chaaban, MD. “We hope that this association study will motivate future studies on the mechanisms underlying our findings and the role of potential confounding factors”
Emerging evidence links acid-suppressive therapy with gut dysbiosis and allergy development. Researchers examined the use of acid-suppressive and antimicrobial medication during infancy to determine the risk of allergy development. Using the US network in the TriNetX platform to aggregate electronic health record data from January 2015 and July 2021 of over 100 million patients in the US, researchers were able to identify patients prescribed PPIs, histamine-2 receptor antagonists (H2RAs) and antimicrobials during their first year of life. Patients with allergy-related encounter diagnoses prior to the prescriptions were excluded from the study.
Researchers assessed two-year outcomes, with ICD-10 encounter diagnoses of food allergy as the primary outcome and ICD-10 encounter diagnoses of anaphylaxis, atopic dermatitis and allergic rhinitis as secondary outcomes. Patients who were prescribed PPIs, H2RAs or antimicrobials demonstrated increased food allergy risk, with PPIs showing highest risk and antimicrobials showing lowest risk to patients. The study found similar results for secondary outcomes.
The outcomes of the study were significant, as infant exposure to acid-suppressive medication was associated with a nearly 6-fold increased risk of food allergy diagnosis in early childhood. Similarly, but to a lesser degree, antimicrobial use during the first year of life showed significantly higher food allergy risk. These findings can support better patient care options and appropriate disclosure of risks when prescribing medications.

Visit to learn more about food allergies. Research presented at the AAAAI Annual Meeting, February 23-26 in Washington, DC, is published in an online supplement to The Journal of Allergy and Clinical Immunology.
The American Academy of Allergy, Asthma & Immunology (AAAAI) is the leading membership organization of more than 7,100 allergists, asthma specialists, clinical immunologists, allied health professionals and other professionals with a special interest in the research and treatment of allergic and immunologic diseases. Established in 1943, the AAAAI has more than 7,100 members in the United States, Canada and 72 other countries and is the go-to resource for patients living with allergies, asthma and immune deficiency disorders.