Antibiotic Use in Early Life, Rural Residence, and Allergic Diseases in Argentinean Children.
BACKGROUND
Little is known about differential effects of antibiotic use on allergic diseases in rural versus urban environments.


OBJECTIVE
To examine whether area of residence in the first year of life modifies the relation between antibiotic use in early life and allergic diseases during childhood.


METHODS
Cross-sectional study of allergic diseases in 1517 children (ages 6-7 years) attending 101 schools in urban and rural areas of San Francisco (Córdoba, Argentina). Current asthma, wheeze, and allergic rhinoconjunctivitis were defined on the basis of responses to a validated questionnaire from the International Study of Asthma and Allergies in Childhood. Multivariate logistic regression was used for the analysis of antibiotic use and allergic diseases.


RESULTS
After adjustment for paracetamol use, bronchiolitis, and other covariates, antibiotic use in the first year of life was associated with increased odds of current wheeze (odds ratio [OR], 1.8; 95% CI, 1.3-2.6) and allergic rhinoconjunctivitis (OR, 1.9; 95% CI, 1.3-2.7). After stratification by area of residence, antibiotic use was associated with current wheeze (OR, 2.4; 95% CI, 1.5-4.0) and allergic rhinoconjunctivitis (OR, 2.1; 95% CI, 1.3-3.4) among children who lived in an urban area in their first year of life, but not among those who lived in a rural area in their first year of life.


CONCLUSIONS
Early-life antibiotic use is associated with current wheeze and allergic rhinoconjunctivitis in Argentinean children who lived in urban areas during their first year of life. Exposure to a rural environment early in life may protect against the adverse effects of antibiotics on atopic diseases in children.
Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
Yueh-Ying
YY
Han
Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
Erick
E
Forno
Department of Pediatric Respiratory Medicine, Regional Eastern Clinic, San Francisco, Córdoba, Argentina.
Héctor A
HA
Badellino
Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa. Electronic address: juan.celedon@chp.edu.
Juan C
JC
Celedón
D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001118:Argentina / Q000453:epidemiology; D001249:Asthma / Q000453:epidemiology; D002648:Child; D003231:Conjunctivitis / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012135:Respiratory Sounds; D065631:Rhinitis, Allergic / Q000453:epidemiology*; D012424:Rural Population; D014505:Urban Population
D000900:Anti-Bacterial Agents
Antibiotics; Asthma; Children; Hay fever; Rural residence; Wheeze