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Pediatr Allergy Immunol. 2017 Aug;28(5):430-437. doi: 10.1111/pai.12725. Epub 2017 Jun 8.

Early life antibiotic use and the risk of asthma and asthma exacerbations in children.

Author information

1
Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of science, Utrecht University, Utrecht, The Netherlands.
2
Department of Respiratory Medicine, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands.
3
Department of Pediatric Pulmonology and Allergology, Department of Pediatrics, University Medical Centre Utrecht, Utrecht, The Netherlands.
4
Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK.
5
Academic Department of Pediatrics, Brighton & Sussex Medical School, Royal Alexandra Children's Hospital, Brighton, UK.
6
Population Pharmacogenetics Group, Biomedical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
7
Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Faculty of Science, Utrecht University, Utrecht, The Netherlands.
8
Nutricia Research, Utrecht, The Netherlands.
9
Population Pharmacogenetics Group, Biomedical Research Centre, University of Dundee, Dundee, UK.
10
Department of Pediatrics, Division of Respiratory Medicine and Allergology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
11
Department of Epidemiology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
12
Division of Neonatology, Department of Pediatrics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
13
Institute for Risk Assessment Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, The Netherlands.

Abstract

BACKGROUND:

The use of antibiotic therapy early in life might influence the risk of developing asthma. Studies assessing the influence of early life antibiotic use on the risk of asthma exacerbations are limited, and the results are inconsistent. Therefore, the aim of this study was to assess the association between use of antibiotic during the first 3 years of life and the risk of developing childhood asthma and the occurrence of asthma exacerbations.

METHODS:

Data from four large childhood cohorts were used; two population-based cohorts to study the risk of developing asthma: Generation R (n=7393, The Netherlands) and SEATON (n=891, Scotland, UK), and two asthma cohorts to assess the risk of asthma exacerbations: PACMAN (n=668, The Netherlands) and BREATHE (n=806, Scotland, UK). Odds ratios (ORs) were derived from logistic regression analysis within each database followed by pooling the results using a fixed- or random-effect model.

RESULTS:

Antibiotic use in early life was associated with an increased risk of asthma in a meta-analysis of the Generation R and SEATON data (OR: 2.18, 95% CI: 1.04-4.60; I2 : 76.3%). There was no association between antibiotic use in early life and risk of asthma exacerbations later in life in a meta-analysis of the PACMAN and BREATHE data (OR: 0.93, 95% CI: 0.65-1.32; I2 : 0.0%).

CONCLUSION:

Children treated with antibiotic in the first 3 years of life are more likely to develop asthma, but there is no evidence that the exposure to antibiotic is associated with increased risk of asthma exacerbations.

KEYWORDS:

antibiotic; asthma; asthma exacerbations; early life; pediatrics

PMID:
28423467
DOI:
10.1111/pai.12725
[Indexed for MEDLINE]

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