Antibiotic Exposure by 6 Months and Asthma and Allergy at 6 Years: Findings in a Cohort of 1,401 US Children

Abstract

Many studies have reported that antibiotic use may be associated with increased risk of childhood asthma. Respiratory tract infections in small children may be difficult to distinguish from early symptoms of asthma, and studies may have been confounded by "protopathic" bias, where antibiotics are used to treat early symptoms of asthma. These analyses of a cohort including 1,401 US children assess the association between antibiotic use within the first 6 months of life and asthma and allergy at 6 years of age between 2003 and 2007. Antibiotic exposure was associated with increased risk of asthma (adjusted odds ratio = 1.52, 95% confidence interval (CI): 1.07, 2.16). The odds ratio if asthma was first diagnosed after 3 years of age was 1.66 (95% CI: 0.99, 2.79) and, in children with no history of lower respiratory infection in the first year of life, the odds ratio was 1.66 (95% CI: 1.12, 3.46). The adverse effect of antibiotics was particularly strong in children with no family history of asthma (odds ratio = 1.89, 95% CI: 1.00, 3.58) (P(interaction) = 0.03). The odds ratio for a positive allergy blood or skin test was 1.59 (95% CI: 1.10, 2.28). The results show that early antibiotic use was associated with asthma and allergy at 6 years of age, and that protopathic bias was unlikely to account for the main findings.

Contributions of Procalcitonin in the Treatment of Neonatal Late Onset Sepsis: A Prospective Observational Study

“…These elements of the digestive flora cause anomalies of the immune system and modify the metabolic programming [16]. A secondary increase in the prevalence of diabetes and obesity, and changes in the immune system with, in particular, the development of lung disease and allergies in adults, have all been reported [17][18][19][20][21].…”

Antibiotic treatment in infants: effect on the gastro-intestinal microbiome and long term consequences

“…26 The adverse effect of antibiotics was particularly strong in children without a family history of asthma (P(interaction)=0.03). 25 Retrospective studies had the highest pooled risk estimate for asthma compared with database and prospective studies. Respiratory infections, later asthma onset (asthma at or after two years) and exposure to antibiotics during pregnancy are all independent risk factor.…”

“…Antibiotics during the first year of life are associated with an increased risk for wheezing and asthma up to the age of three and six years, independent of lower respiratory tract infections during the first year of life. [24][25][26][27][28] The strength of the association differs with the class of antibiotics, correlating with their effect on the gastrointestinal microbiome. 24 A dose-response effect was observed: when five or more antibiotic courses were administered, the risk to develop asthma increased significantly (p<001).…”

Intestinal Microbiota: Early Formation, Health Effects, and Correction Ways

“…Небла-го приятно сказывается антибиотикотерапия кормящих матерей в послеродовом периоде и на микробиоте груд-ного молока: уменьшается количество бифидо-и лакто-бактерий в грудном молоке, а в кишечной микробиоте ребенка, соответственно, увеличивается относительное содержание Clostridium difficile и Enterococcus [31,32]. Антибиотикотерапия новорожденных коррелирует с раз-витием в старшем возрасте астмы, аллергии и ожирения [33,34]. Исключительно грудное вскармливание в тече-ние первых 6 мес может во многом нивелировать изме-нения в составе кишечной микробиоты у младенцев, чьи матери получали антибиотикотерапию [29].…”