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Comment & Response
October 2018

Antibiotics and Acid-Suppressing Medications in Early Life and Allergic Disorders

Author Affiliations
  • 1Section of Allergy and Immunology, Children’s Hospital Colorado, University of Colorado School of Medicine, Aurora
  • 2Nationwide Children’s Hospital, The Ohio State University College of Medicine, Columbus
  • 3BC Children’s Hospital, Division of Allergy and Immunology, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
JAMA Pediatr. 2018;172(10):987-988. doi:10.1001/jamapediatrics.2018.2510

To the Editor The study by Mitre et al1 is concerning given incomplete acknowledgment of limitations and questionable accuracy of associations between antireflux and antibiotic use independently increasing the risk of developing allergic diseases.1 Using International Classification of Diseases, Ninth Revision codes to indicate a diagnosis of allergic conditions is often inaccurate without additional encounter-level details verifying a history consistent with the condition and confirmatory testing. These diagnoses were not linked to allergist referral and confirmatory coding, evidence of allergen sensitization, abnormal pulmonary function testing, or treatment of the diagnosis.2 This raises concerns of misspecified associations with risk.

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