title: Association of prevalence of rhinitis, atopic eczema, rhinoconjunctivitis and wheezing with mortality from infectious diseases and with antibiotic susceptibility at a country level.
abstract: BACKGROUND
  It was previously reported that there is a positive correlation between incidence of type 1 diabetes and prevalence of asthma and atopic eczema. A negative correlation between the prevalence of type 1 diabetes and mortality from infectious diseases as well as a positive correlation with antibiotic susceptibility at a country level have also been reported.
  
  
  OBJECTIVE
  The aim of this study was to investigate the association between country prevalence of rhinitis, atopic eczema, rhinoconjunctivitis, and wheezing with mortality from infectious diseases and also with antibiotic susceptibility at a country level.
  
  
  METHODS
  Data for prevalence of rhinitis, eczema, rhinoconjunctivitis, and wheezing was obtained from the International Study of Asthma and Allergies in Childhood study (ISAAC). ISAAC Phase one was a multicentre multicountry cross sectional study involving over 700,000 children in 2 age groups of school children, 13-14 years old (adolescents) and 6-7 years old (children) in 156 centres from 56 countries. Mortality from infectious diseases was taken from World Health Organisation data. The Alexander project was used to identify antibiotic susceptibilities to common bacteria.
  
  
  RESULTS
  There were significant positive correlations between atopic eczema and mortality from all infectious diseases studied, diarrhoeal illness, tropical infections, and childhood infections. A negative correlation exists between the prevalence of rhinitis and Streptococcus pneumoniae susceptibility to penicillin and to erythromycin, rhinitis and Haemophilus influenzae susceptibility to ampicillin and between rhinoconjunctivitis and H. influenzae susceptibility to ampicillin.
  
  
  CONCLUSIONS
  Th1/Th2 responses might influence the pathogenesis of infectious disease mortality, while antibiotic overprescription could explain the negative association between atopy and antibiotic susceptibility.
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta.
authors.forename: Claudia
authors.initials: C
authors.lastname: Fsadni
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta.
authors.forename: Peter
authors.initials: P
authors.lastname: Fsadni
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta.
authors.forename: Stephen
authors.initials: S
authors.lastname: Fava
authors.affiliation: Department of Medicine, Mater Dei Hospital, Msida, MSD 2090, Malta. ; Faculty of Medicine and Surgery, University of Malta, Msida, MSD 2090, Malta.
authors.forename: Stephen
authors.initials: S
authors.lastname: Montefort
keywords: Anti-Infective Agents; Asthma; Communicable Diseases; Conjunctivitis, Allergic; Eczema; Rhinitis