Effect of antibiotic use for acute bronchiolitis on new-onset asthma in children

Chen, I‐Lun; Huang, Hsin‐Chun; Chang, Yo-Chen; Huang, Hsin‐Yi; Yeh, Wei-Ju; Wu, Ting-Yi; Suen, Jau‐Ling; Yang, San‐Nan; Hung, Chih‐Hsing

doi:10.1038/s41598-018-24348-5

Cited by 18 publications

(25 citation statements)

References 24 publications

(29 reference statements)

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“…However, the long-term use of antibiotics results in the emergence of drug-resistant strains [12]. At the same time, an increasing number of studies have shown that children and pregnant women exposed to antibiotics are at increased risk of asthma later in life or in their newborn babies, and this risk is positively correlated with an increased antimicrobial spectrum and an increased antibiotic dosage [69][70][71][72]. The GINA report does not support the use of antibiotics for asthma, and it is recommended that antibiotics should not be routinely used to treat exacerbations of asthma unless there is definitive evidence of pulmonary infection (e.g., radiological evidence of pneumonia, fever or suppurative sputum) [2].…”

Section: Use Of Antibioticsmentioning

confidence: 99%

The role of NTHi colonization and infection in the pathogenesis of neutrophilic asthma

et al. 2020

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Asthma is a complex heterogeneous disease. The neutrophilic subtypes of asthma are described as persistent, more severe and corticosteroid-resistant, with higher hospitalization and mortality rates, which seriously affect the lives of asthmatic patients. With the development of high-throughput sequencing technology, an increasing amount of evidence has shown that lower airway microbiome dysbiosis contributes to the exacerbation of asthma, especially neutrophilic asthma. Nontypeable Haemophilus influenzae is normally found in the upper respiratory tract of healthy adults and is one of the most common strains in the lower respiratory tract of neutrophilic asthma patients, in whom its presence is related to the occurrence of corticosteroid resistance. To understand the pathogenic mechanism by which nontypeable Haemophilus influenzae colonization leads to the progression of neutrophilic asthma, we reviewed the previous literature on nontypeable Haemophilus influenzae colonization and subsequent aggravation of neutrophilic asthma and corticosteroid resistance. We discussed nontypeable Haemophilus influenzae as a potential therapeutic target to prevent the progression of neutrophilic asthma.

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Section: Use Of Antibioticsmentioning

confidence: 99%

The role of NTHi colonization and infection in the pathogenesis of neutrophilic asthma

et al. 2020

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“…[7][8][9] There is also evidence that identifying RSV in infants who were affected was independently associated with discontinuation of antibiotics during hospitalization; however, it is unclear whether the issuance of guidelines can affect the use of antibiotics. [10][11][12] Our primary study aim was to examine antibiotic prescribing practices as part of the inpatient management of bronchiolitis at a single tertiary care pediatric hospital before and after the publication of the CPS guidelines in November 2014. Given concerns about the overuse of antibiotics as a major contributor to antibiotic resistance, we wanted to determine if the release of national guidelines was associated with a reduction in antibiotic use for this illness.…”

mentioning

confidence: 99%

Antibiotic Use for Inpatient Bronchiolitis: Did National Guidelines Impact Practice at a Pediatric Hospital?

Lopez¹,

Aslanova

Bridger

et al. 2020

Hospital Pediatrics

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BACKGROUND AND OBJECTIVES: Bronchiolitis is a common lower respiratory tract infection that affects infants and young children. Because of variability in physician practice, inpatient management varies among pediatricians. In 2014, the Canadian Pediatric Society published national guidelines aimed at standardizing the inpatient management of this illness, which included recommending against the need for antibiotics for most patients. The study objective was to evaluate antibiotic prescription and supportive investigations for inpatient management of bronchiolitis before and after the publication of national guidelines. METHODS: This study was a single-center retrospective chart review of inpatients with bronchiolitis. We included healthy children 1 to 24 months of age who were admitted from November 2011 to October 2016. Those admitted before December 2014 were analyzed in the preguidelines cohort; the remaining, in the postguidelines cohort. The main outcome was antibiotic prescription. The secondary outcome was the frequency of chest radiographs, nasopharyngeal swabs, and blood cultures. RESULTS: A total of 131 patients were included in the first cohort; 71, in the second cohort. The rates of antibiotic initiation were almost equal in both cohorts (∼44%; P 5 .98). More antibiotics were discontinued during hospitalization in the second cohort compared with the first cohort (10% vs 20%; P 5 .001). Significantly fewer patients were discharged with antibiotics in the second cohort (31% vs 16%; P 5 .02). CONCLUSIONS: Our study revealed a reduction in antibiotic use after the release of national guidelines, illustrating that antibiotic prescribing practices can change. However, there is still a pressing need for local initiatives to continue to reduce the unnecessary use of antibiotics within the pediatric setting.

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“…Our previous study also concluded that, in children, 5 preceding years of antibiotic exposure, predominantly to amoxicillin and macrolides, was associated with the risk of asthma development in AR and in bronchiolitis 17 , 18 . However, the risk of the development of new-onset asthma in AD patients due to early-life antibiotic exposure is still unknown.…”

Section: Introductionmentioning

confidence: 66%

The effects of antibiotic exposure on asthma in children with atopic dermatitis

Chen

Tsai

Chung

et al. 2021

Sci Rep

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Early-life antibiotic use is associated with allergic diseases. The risk factors for the progression from atopic dermatitis (AD) to asthma or allergic rhinitis are still unknown. We aimed to investigate the association between exposure to different antibiotics and the risk of new-onset asthma in children with AD. By using the Longitudinal Health Insurance Database 2005, we selected AD patients less than 6 years old identified by ICD-9-CM code 691.8. The case group was defined as those having new-onset asthma, and the control group was defined as those without an asthma history. Information on antibiotic exposure in the 5 years prior to the index date was collected from drug prescription records. We estimated the adjusted odds ratio by using conditional logistic regression, adjusted for age, sex, index year, other potential risk factors and antibiotics. Antibiotic exposure was associated with the development of asthma in patients with AD (aOR = 3.68, 95% CI 2.13–6.36), particularly for patients less than 5 years old (aOR = 4.14, 95% CI 2.24–7.64) (p for trend < 0.001), even though lower cumulative antibiotic defined daily doses (DDDs) were associated with new-onset asthma occurrence. Antibiotic exposure, especially macrolide exposure, is associated with an increased risk of asthma in patients with AD.

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Effect of antibiotic use for acute bronchiolitis on new-onset asthma in children

Cited by 18 publications

References 24 publications

The role of NTHi colonization and infection in the pathogenesis of neutrophilic asthma

The role of NTHi colonization and infection in the pathogenesis of neutrophilic asthma

Antibiotic Use for Inpatient Bronchiolitis: Did National Guidelines Impact Practice at a Pediatric Hospital?

The effects of antibiotic exposure on asthma in children with atopic dermatitis

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