Prenatal or Early-Life Exposure to Antibiotics and Risk of Childhood Asthma: A Systematic Review

Murk, William; Risnes, Kari; Bracken, Michael B.

doi:10.1542/peds.2010-2092

Cited by 246 publications

(181 citation statements)

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“…Under this view, commonly referred to as the "hygiene hypothesis," restricted microbial exposure leads to inadequate "priming" of the immune system during maturation, resulting in helper T type 1 (Th1)-Th2 cell subset imbalances, regulatory T cell deficiency, and innate immune abnormalities. Changes in diet, improved sanitary conditions, and increased use of antibiotics may limit the exposure to environmental microbes and be responsible for the increase in autoimmune diseases observed more recently (49,(52)(53)(54)(55)(56)(57). In a mouse model, inhalation of an innocuous strain of Escherichia coli could reprogram dendritic cells and macrophages in the lungs, resulting in protection against allergic responses (58).…”

Section: What Is the Role Of The Airway Microbiota?mentioning

confidence: 99%

Lung Microbiome for Clinicians. New Discoveries about Bugs in Healthy and Diseased Lungs

2014

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Microbes are readily cultured from epithelial surfaces of the skin, mouth, and colon. In the last 10 years, culture-independent DNAbased techniques demonstrated that much more complex microbial communities reside on most epithelial surfaces; this includes the lower airways, where bacterial culture had failed to reliably demonstrate resident bacteria. Exposure to a diverse bacterial environment is important for adequate immunological development. The most common microbes found in the lower airways are also found in the upper airways. Increasing abundance of oral characteristic taxa is associated with increased inflammatory cells and exhaled nitric oxide, suggesting that the airway microbiome induces an immunological response in the lung. Furthermore, rhinovirus infection leads to outgrowth of Haemophilus in patients with chronic obstructive pulmonary disease, and human immunodeficiency virus-infected subjects have more Tropheryma whipplei in the lower airway, suggesting a bidirectional interaction in which the host immune defenses also influence the microbial niche. Quantitative and/or qualitative changes in the lung microbiome may be relevant for disease progression and exacerbations in a number of pulmonary diseases. Future investigations with longitudinal follow-up to understand the dynamics of the lung microbiome may lead to the development of new therapeutic targets.

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Section: What Is the Role Of The Airway Microbiota?mentioning

confidence: 99%

Lung Microbiome for Clinicians. New Discoveries about Bugs in Healthy and Diseased Lungs

2014

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“…Alternatively, the association between antibiotic use during pregnancy and childhood wheezing/asthma might stem from various confounding factors [21]. Potential confounders include risk factors for both maternal and childhood infections and wheezing such as maternal smoking and asthma, both associated with a greater risk of respiratory infections, and perinatal infections, e.g.…”

Section: Introductionmentioning

confidence: 99%

Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

et al. 2015

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The role of prenatal antibiotic exposure in the development of childhood wheezing is debated. We evaluated whether this association could potentially be explained by confounding factors.Antibiotic use in the first and third trimester of pregnancy, wheezing in children aged ⩽18 months and confounding factors were assessed in singletons participating in the NINFEA (Nascita e Infanzia: gli Effetti dell'Ambiente) birth cohort (n=3530 for first-trimester exposure and n=3985 for third-trimester exposure).There was no evidence of an association between antibiotic exposure in the first trimester of pregnancy and ever-wheezing (adjusted risk ratio (RR) 1.02, 95% CI 0.80-1.30) or recurrent wheezing (RR 0.99, 95% CI 0.54-1.82). For the third-trimester exposure, the crude RRs (95% CI) of ever-wheezing and recurrent wheezing were 1.34 (1.10-1.64) and 2.72 (1.80-4.11), respectively, which decreased to 1.12 (0.90-1.39) and 2.09 (1.32-3.29) after adjustment. The RRs of wheezing after genitourinary infections during pregnancy were increased independently of antibiotic treatment.In conclusion, the association between prenatal antibiotic exposure and infant wheezing could be largely explained by confounding factors, in particular respiratory infections during pregnancy. An excess risk of wheezing after antibiotic exposure during the third trimester of pregnancy remains after adjustment. @ERSpublications Confounders explain increased risk of infant wheeze after antibiotic exposure in the first but not third trimester

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“…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).…”

Section: Antibiotics and The Respiratory Tractmentioning

confidence: 99%

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

2018

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Introduction: The gastrointestinal microbiome is crucial for the development of a balanced immune system. Antibiotics are frequently administered to infants and cause intestinal dysbiosis. This narrative review highlights the long term health consequences of antibiotic administration to infants and young children. The necessity of administration of antibiotics should be well considered, since an association with short term consequences such as antibiotic associated diarrhoea and long term adverse effects such as overweight, inflammatory bowel syndrome, allergic disease have been reported. Conclusion:The pros and cons of antibiotic administration to infants and young children should be considered.

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Prenatal or Early-Life Exposure to Antibiotics and Risk of Childhood Asthma: A Systematic Review

Abstract: Antibiotics seem to slightly increase the risk of childhood asthma. Reverse causality and protopathic bias seem to be possible confounders for this relationship.

Cited by 246 publications

References 50 publications

Lung Microbiome for Clinicians. New Discoveries about Bugs in Healthy and Diseased Lungs

Lung Microbiome for Clinicians. New Discoveries about Bugs in Healthy and Diseased Lungs

Prenatal exposure to antibiotics and wheezing in infancy: a birth cohort study

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

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