Antibiotic Use in Early Life, Rural Residence, and Allergic Diseases in Argentinean Children

Abstract

Background Little is known about differential effects of antibiotic use on allergic diseases in rural versus urban environments. Objective: To examine whether area of residence in the first year of life modifies the relation between antibiotic use in early life and allergic diseases during childhood. Methods Cross-sectional study of allergic diseases in 1,517 children (ages 6–7 years) attending 101 schools in urban and rural areas of San Francisco (Córdoba, Argentina). Current asthma, wheeze, and allergic rhino-conjunctivitis were defined on the basis of responses to a validated questionnaire from the International Study of Asthma and Allergies in Childhood (ISAAC). Multivariate logistic regression was used for the analysis of antibiotic use and allergic diseases. Results After adjustment for paracetamol use, bronchiolitis, and other covariates, antibiotic use in the first year of life was associated with increased odds of current wheeze (odds ratio [OR]=1.8, 95% confidence interval [CI]=1.3–2.6) and allergic rhino-conjunctivitis (OR=1.9, 95% CI=1.3–2.7). After stratification by area of residence, antibiotic use was associated with current wheeze (OR=2.4, 95% CI=1.5–4.0) and allergic rhino-conjunctivitis (OR=2.1, 95% CI=1.3–3.4) among children who lived in an urban area in their first year of life, but not among those who lived in a rural area in their first year of life. Conclusions Early-life antibiotic use is associated with current wheeze and allergic rhino-conjunctivitis in Argentinean children who lived in urban areas during their first year of life. Exposure to a rural environment early in life may protect against the adverse effects of antibiotics on atopic diseases in children.

Maternal antibiotic exposure during pregnancy and the risk of allergic diseases in childhood: A meta‐analysis

“…It should be noted that much evidence suggested postnatal exposure to antibiotics might increase the risk of the development of allergic diseases in children. [10][11][12][13][14][15][16][17] For instance, Ahmadizar et al 10 found a positive association between early-life antibiotic exposure and the risk of developing symptoms such as eczema, hay fever, and food allergy later in life through meta-analyses.…”

“…Some studies reported that maternal antibiotic exposure during pregnancy was associated with an altered infant gut microbiome composition 8,9 which may lead to subsequent allergy diseases and obesity in childhood. It should be noted that much evidence suggested postnatal exposure to antibiotics might increase the risk of the development of allergic diseases in children 10‐17 . For instance, Ahmadizar et al 10 found a positive association between early‐life antibiotic exposure and the risk of developing symptoms such as eczema, hay fever, and food allergy later in life through meta‐analyses.…”

<p>Antibiotic overuse and allergy-related diseases: an epidemiological cross-sectional study in the grasslands of Northern China</p>

“…Recent studies suggest that antibiotics in the first few years of life have been associated with increased risks of allergic disease in later childhood 14. Some studies have shown that exposure and use of antibiotics in infants may increase the risk of AR or asthma 5,6,15,16. Other studies have shown that there is a direct relationship between antibiotic use in the first 3 years of life and asthma and allergy symptoms in children aged 6–8 years old 17.…”

Important Role of Immunological Responses to Environmental Exposure in the Development of Allergic Asthma

“…Antibiotic exposure during maternal pregnancy or early life 67 68 69 70 71 and cesarean delivery 57 72 73 can increase the prevalence of asthma in children by affecting the gut microbiota and other mechanisms. Anti-parasitic therapy is also shown to be associated with increased prevalence of asthma.…”