title: Early-life antibiotic use is associated with wheezing among children with high atopic risk: a prospective European study.
abstract: BACKGROUND
  Little is known about the relationship between antibiotic use and asthma in the children with a higher risk of allergic sensitization. We examine the association between the use of specific therapeutic antibiotics in the first year of life and development of wheezing by 36 months among children with a higher risk of allergic sensitization.
  
  
  METHODS
  A multi-center prospective cohort study was conducted among children at high risk for allergic sensitization. A validated questionnaire was used to prospectively collect information on antibiotic use and potential risk factors for wheezing from parents or guardians of 606 children from three European countries at 6, 12, 24 and 36 months of age. Multivariate linear and logistic regression models were used to adjust for potential confounders and effect modifiers and to estimate the association of antibiotic use with the development of early childhood wheezing.
  
  
  RESULTS
  Of the antibiotics assessed, only macrolide use in the first year of life was associated with increasing risk for wheezing by 36 months, after adjusting for gender, socioeconomic status, breast feeding >6 months, tobacco smoke exposure, family history of asthma, and respiratory infection (RR = 1.09; 95% CI 1.05-1.13). To avoid a bias by indication, we analyzed children with and without respiratory infection separately. Similar associations were observed for macrolides use in children who had no respiratory infection.
  
  
  CONCLUSIONS
  In European children with a familial risk for allergic sensitization, we found a positive association between macrolide use in the first year of life and wheezing until 36 months old which was independent of the effect of respiratory infection.
authors.affiliation: a School of Food Science, Guangdong Pharmaceutical University , Zhongshan , China .
authors.forename: Wenjie
authors.initials: W
authors.lastname: Sun
authors.forename: Erik R
authors.initials: ER
authors.lastname: Svendsen
authors.forename: Wilfried J J
authors.initials: WJ
authors.lastname: Karmaus
authors.forename: Joachim
authors.initials: J
authors.lastname: Kuehr
authors.forename: Johannes
authors.initials: J
authors.lastname: Forster
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001942:Breast Feeding; D002675:Child, Preschool; D005060:Europe; D005260:Female; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000453:epidemiology*; D007223:Infant; D018942:Macrolides / Q000009:adverse effects*; D008297:Male; D011446:Prospective Studies; D012135:Respiratory Sounds / Q000209:etiology*; D012307:Risk Factors
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides
keywords: Antibiotic use; children; prospective cohort; wheezing