Antibiotic use in children is associated with increased risk of asthma.
BACKGROUND
Antibiotic exposure in early childhood is a possible contributor to the increasing asthma prevalence in industrialized countries. Although a number of published studies have tested this hypothesis, the results have been conflicting.


OBJECTIVE
To explore the association between antibiotic exposure before 1 year of age and development of childhood asthma.


METHODS
Using administrative data, birth cohorts from 1997 to 2003 were evaluated (N = 251817). Antibiotic exposure was determined for the first year of life. After the first 24 months of life, the incidence of asthma was determined in both those exposed and not exposed to antibiotics in the first 12 months of life. Cox proportional hazards models were used to adjust for potential confounders and determine the hazard ratios associated with antibiotic exposure for the development of asthma.


RESULTS
Antibiotic exposure in the first year of life was associated with a small risk of developing asthma in early childhood after adjusting for gender, socioeconomic status at birth, urban or rural address at birth, birth weight, gestational age, delivery method, frequency of physician visits, hospital visit involving surgery, visits to an allergist, respirologist, or immunologist, congenital anomalies, and presence of otitis media, acute, or chronic bronchitis, and upper and lower respiratory tract infections during the first year of life. As the number of courses of antibiotics increased, this was associated with increased asthma risk, with the highest risk being in children who received >4 courses. All antibiotics were associated with an increased risk of developing asthma, with the exception of sulfonamides.


CONCLUSIONS
This study provides evidence that the use of antibiotics in the first year of life is associated with a small risk of developing asthma, and this risk increases with the number of courses of antibiotics prescribed.
Marra
Fawziah
F
University of British Columbia, Faculty of Pharmaceutical Sciences, Centre for Health Evaluation and Outcomes Sciences, St Paul's Hospital, 620-1081 Burrard St, Vancouver, British Columbia, Canada. carlo.marra@ubc.ca
Marra
Carlo A
CA
Richardson
Kathryn
K
Lynd
Larry D
LD
Kozyrskyj
Anita
A
Patrick
David M
DM
Bowie
William R
WR
Fitzgerald
J Mark
JM
D000900:Anti-Bacterial Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D001955:British Columbia; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008137:Longitudinal Studies; D008297:Male; D016016:Proportional Hazards Models; D012307:Risk Factors
D000900:Anti-Bacterial Agents