Increased risk of childhood asthma from antibiotic use in early life.
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.
Kozyrskyj
Anita L
AL
Faculty of Pharmacy, University of Manitoba, Winnipeg, MB, Canada R3T 2N2. kozyrsk@cc.umanitoba.ca
Ernst
Pierre
P
Becker
Allan B
AB
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001249:Asthma / Q000453:epidemiology*; D002511:Cephalosporins / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D004342:Drug Hypersensitivity / Q000453:epidemiology; D005260:Female; D006801:Humans; D007223:Infant; D007229:Infant Welfare; D008137:Longitudinal Studies; D008297:Male; D008350:Manitoba / Q000453:epidemiology; D016017:Odds Ratio; D012141:Respiratory Tract Infections / Q000188:drug therapy; D012307:Risk Factors
D000900:Anti-Bacterial Agents; D002511:Cephalosporins