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

Fariba Ahmadizar, Susanne J. H. Vijverberg, Hubertus G. M. Arets, Anthonius de Boer, Steve Turner, Graham Devereux, Ali Arabkhazaeli, Patricia Soares, Somnath Mukhopadhyay, Johan Garssen, Colin N. A. Palmer, Johan C. de Jongste, Vincent W. V. Jaddoe, Liesbeth Duijts, Evelien R. van Meel, Aletta D. Kraneveld, Anke H. Maitland-van der Zee (Lead / Corresponding author)

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    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 three 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=7,393, 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; I(2) : 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; I(2) : 0.0%).

    Conclusion: Children treated with antibiotic in the first three 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. This article is protected by copyright. All rights reserved.

    Original languageEnglish
    Pages (from-to)430-437
    Number of pages8
    JournalPediatric Allergy and Immunology
    Volume28
    Issue number5
    Early online date19 Apr 2017
    DOIs
    Publication statusPublished - Aug 2017

    Keywords

    • Antibiotic
    • Asthma
    • Asthma exacerbations
    • Early life
    • Pediatrics

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