This meta-analysis aimed to investigate the correlation between early-life antibiotic use and allergic rhinitis. PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched for available studies. Eighteen studies covering 1,768,874 children were included. Early-life antibiotics were associated with an increased incidence of allergic rhinitis (effect size (ES) = 5.00, 95% confidence interval [CI]: 4.88–5.13; I 2 = 95.7%, P heterogeneity <0.001). In Asia, Europe, and the USA, the incidence of allergic rhinitis in the antibiotic group was higher than that in the no medication group (Asia: ES = 3.68, 95% CI: 3.38–4.01; Europe: ES = 3.20, 95% CI: 3.00–3.42; USA: ES = 3.68, 95% CI: 2.74–4.95). Compared with the no medication group, children who received antibiotics in the first 1 week of life (ES = 5.75, 95% CI: 2.18–15.18), first 1 year of life (ES = 3.37, 95% CI: 3.20–3.55; I 2 = 64.2%, P heterogeneity = 0.001), or first 3 years of life (ES = 5.21, 95% CI: 2.42–11.19) had a higher incidence of allergic rhinitis. No individual study influenced the estimates of the meta-analysis. The funnel plot showed moderate symmetry and low publication bias. In conclusion, the use of antibiotics in early life was associated with allergic rhinitis. Still, most included studies analyzed antibiotic exposure as a dichotomous variable, without information on the type and dosage of antibiotics.
Background: Tracheobronchial foreign body aspiration (TFBA) is a major cause of death in children. There are few reports about lower respiratory tract infection (LRTI) caused by TFBA. This study collected the TFBA in our hospital to analyze the LRTI and to determine its risk factors. Methods: A total of 194 children who were performed TFBA extraction in The Children’s Hospital of Zhejiang University School of Medicine between June 2019 and April 2020 were enrolled. The clinical data, cervicothoracic CT and operation records were collected. Chi-square test, rank sum test and multivariate logistics regression analysis were applied. Results: The incidence of LRTI was 46.6%, 68.6% and 68.6% respectively when retention time was within 24 hours, 1 week and more than 1 week. Cervicothoracic CT showed embedding site in and above trachea in 24 cases, in main bronchus in 134 cases, in segmental bronchus and below in 36 cases. Cervicothoracic CT showed no obvious abnormality in 60 cases, obstructive emphysema or atelectasis in 77 cases, obstructive pneumonia in 50 cases, and the rest in 7 cases. Cervicothoracic CT diagnosis and retention time of TFBA were different between LRTI group and non-LRTI group in univariate analysis. There was a correlation between the retention time of TFBA and LRTI in multivariate logistics regression analysis. Conclusionss: The incidence of LRTI caused by TFBA is high. There was no difference in the incidence of LRTI between organic and inorganic TFBA. The retention time of TFBA is an independent risk factor for LRTI.
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