BACKGROUND: To address the major methodological issues of reverse causation and selection bias in epidemiologic studies of antibiotic use in early life and the development of asthma, we undertook a cohort study of this association in a complete population of children. METHODS: Using the health-care and prescription databases of Manitoba, Canada, this longitudinal study assessed the association between antibiotic prescription use during the first year of life and asthma at age 7 years in a 1995 birth cohort of 13,116 children. RESULTS: Independent of well-known asthma risk factors, asthma was significantly more likely to develop in children who had received antibiotics in the first year of life at age 7 years. The association with asthma was observed for antibiotic use in non-respiratory tract infections (adjusted odds ratio [OR], 1.86; 95% confidence interval [CI], 1.02 to 3.37). The risk of asthma was highest in children receiving more than four courses of antibiotics (adjusted OR, 1.46; 95% CI, 1.14 to 1.88), especially among rural children, and in the absence of maternal asthma or a dog in the birth year. Broad-spectrum (BS) cephalosporin use was more common in these subpopulations of children. CONCLUSIONS: Antibiotic use in early life was associated with the development of childhood asthma, a risk that may be reduced by avoiding the use of BS cephalosporins.
BACKGROUND: To address the major methodological issues of reverse causation and selection bias in epidemiologic studies of antibiotic use in early life and the development of asthma, we undertook a cohort study of this association in a complete population of children. METHODS: Using the health-care and prescription databases of Manitoba, Canada, this longitudinal study assessed the association between antibiotic prescription use during the first year of life and asthma at age 7 years in a 1995 birth cohort of 13,116 children. RESULTS: Independent of well-known asthma risk factors, asthma was significantly more likely to develop in children who had received antibiotics in the first year of life at age 7 years. The association with asthma was observed for antibiotic use in non-respiratory tract infections (adjusted odds ratio [OR], 1.86; 95% confidence interval [CI], 1.02 to 3.37). The risk of asthma was highest in children receiving more than four courses of antibiotics (adjusted OR, 1.46; 95% CI, 1.14 to 1.88), especially among rural children, and in the absence of maternal asthma or a dog in the birth year. Broad-spectrum (BS) cephalosporin use was more common in these subpopulations of children. CONCLUSIONS: Antibiotic use in early life was associated with the development of childhood asthma, a risk that may be reduced by avoiding the use of BS cephalosporins.
Authors: K P Economopoulos; N L Ward; C D Phillips; A Teshager; P Patel; M M Mohamed; S Hakimian; S B Cox; R Ahmed; O Moaven; K Kaliannan; S N Alam; J F Haller; A M Goldstein; A K Bhan; M S Malo; R A Hodin Journal: Diabetes Obes Metab Date: 2016-03-22 Impact factor: 6.577
Authors: Peter J Turnbaugh; Ruth E Ley; Micah Hamady; Claire M Fraser-Liggett; Rob Knight; Jeffrey I Gordon Journal: Nature Date: 2007-10-18 Impact factor: 49.962
Authors: A G Hirsch; J Pollak; T A Glass; M N Poulsen; L Bailey-Davis; J Mowery; B S Schwartz Journal: Clin Exp Allergy Date: 2016-10-14 Impact factor: 5.018