First-Year Antibiotics Exposure in Relation to Childhood Asthma, Allergies, and Airway Illnesses

Abstract

Background: Associations of early antibiotics exposures with childhood asthma, allergies, and airway illnesses are debated. Objectives: We aimed to investigate associations of first-year antibiotics exposure with childhood asthma, allergies, and airway illnesses. Methods: A cross-sectional study was conducted among preschoolers in Shanghai, China during 2011–2012. A questionnaire regarding household environment and lifestyles and childhood health outcomes was reported by the child’s parents. Results: In total, 13,335 questionnaires (response rate: 85.3%) were analyzed and 3049 (24.1%) children had first-year antibiotics exposure. In the multivariate logistic regression analyses, first-year antibiotics exposure had significant associations with the higher odds of lifetime-ever pneumonia (adjusted OR, 95% CI: 2.15, 1.95–2.37), croup (1.46, 1.24–1.73), wheeze (1.44, 1.30–1.60), asthma (1.38, 1.19–1.61), food allergy (1.29, 1.13–1.46), and allergic rhinitis (1.23, 1.07–1.41), and as well as current (one year before the survey) common cold (≥3 times) (1.38, 1.25–1.52), dry cough (1.27, 1.13–1.42), atopic dermatitis (1.25, 1.09–1.43), wheeze (1.23, 1.10–1.38), and rhinitis symptoms (1.15, 1.04–1.26). These associations were different in children with different individual characteristics (age, sex, family history of atopy, and district) and other early exposures (breastfeeding, home decoration, pet-keeping, and environmental tobacco smoke). Conclusions: Our results indicate that first-year antibiotics exposure could be a strong risk factor for childhood pneumonia, asthma, allergies, and their related symptoms. The individual characteristics and other early exposures may modify effects of early antibiotic exposure on childhood allergies and airway illnesses.

Risk factors for allergic diseases: a cross-sectional survey of 9,501 Chinese preschool-aged children

“…Besides, we also found that antibiotic use during childhood played a leading role in susceptibility to allergic diseases, consistent with the observations of most previous studies (20,21). This finding is biologically plausible.…”

Antibiotic exposure and adverse long-term health outcomes in children: A systematic review and meta-analysis

“…Forty studies in 1,602,639 children (183,244 cases with one study not reporting number of cases) investigated the association between antibiotic exposure and the risk of developing atopic dermatitis, evaluated by the International Study of Allergy and Asthma in Childhood (ISAAC) questionnaire, international classification of disease (ICD) codes, parent-reported symptoms or physician's diagnosis, the Criteria by the American Academy of Dermatology, Hanifin and Rajka criteria or William's criteria (table 1). 32,37,40,43,[48][49][50][51]53,62,79,80,82,93,96,98,103,105,114,120,123,129,135,150,[153][154][155]157,161,162,[172][173][174][175][176][177][178][179][180][181] Of the 40 studies, 38 (95%) investigated the effect of antibiotic exposure in the first five years of life (36 (90%) in the first two years of life). 32,…”

“…32,37,40,43,[48][49][50][51]53,62,79,80,82,93,96,98,103,105,114,120,123,129,135,150,[153][154][155]157,161,162,[172][173][174][175][176][177][178][179][180][181] Of the 40 studies, 38 (95%) investigated the effect of antibiotic exposure in the first five years of life (36 (90%) in the first two years of life). 32,37,40,43,[48][49][50][51]53,62,79,…”

Intestinal Microbiota—A Promising Target for Antiviral Therapy?

“…A case-control study of Kawasaki disease (KD), including 50 patients and 200 control subjects, showed that the development of KD was associated with previous antibiotic administration and that antibiotics might contribute to the development of KD by affecting the intestinal microbiota in infants and young children ( 149 ). Additionally, long-term antibiotic exposure has been associated with an increased risk for several diseases, such as type 2 diabetes ( 150 ), inflammatory bowel diseases ( 151 ), and asthma ( 152 ). Therefore, the interaction of antibiotics and intestinal microbiota must be taken into account when administrating antibiotics.…”