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

Abstract

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.

The prenatal and postnatal effects of air pollution on asthma in children with atopic dermatitis

“…39 However, indoor PM is hard to monitor by the government because of the private area. Also, the risk of developing asthma in children with AD included antibiotics use, 40 which was not matched between groups before analysis.…”

Prenatal and postnatal exposure to antibiotics and risk of food allergy in the offspring: A nationwide birth cohort study in South Korea

“…7 The administration of antibiotics during pregnancy and young infancy is become increasingly prevalent and antibiotics account for ~30% and ~80% of total prescribed medications dispensed to preschool children and pregnant women, respectively. 8 At the same time, mounting evidence suggests that prenatal exposure to antibiotics may increase the risk of chronic diseases including asthma [9][10][11][12][13][14] and atopic dermatitis. 15 However, only one study has investigated the association between early antibiotic exposure and childhood food allergy at the population level.…”

Antibiotic exposures could lead to overestimation of incident outcomes—a commentary on “Prevalence of type 2 inflammatory diseases in pediatric patients with atopic dermatitis: real-world evidence”

“…It was assumed that an imbalance of the gut microbiome and a damaged intestinal epithelium could pose a higher risk of the exacerbation of ''allergic march,'' leading to elevated immunoglobulin E-related allergic reactions and aeroallergen sensitization. 3,4 Moreover, according to several real-world evidences, antibiotic exposure was reported to have association with increasing risk of future allergic diseases, including asthma and allergic rhinitis. 2,4,5 Given the potential use of antibiotics for infections in children, the issue could be a critical confounder influencing the result.…”

“…3,4 Moreover, according to several real-world evidences, antibiotic exposure was reported to have association with increasing risk of future allergic diseases, including asthma and allergic rhinitis. 2,4,5 Given the potential use of antibiotics for infections in children, the issue could be a critical confounder influencing the result. However, since comedication records and maternal information in the baseline were not available in the current study, readers should be careful while interpreting the reported results.Issues regarding medical surveillance could also have influenced the results.…”