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This Article Full Text (PDF) Free All Versions of this Article: chest.06-3008v1 131/6/1753    most recent Submit a response View responses Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to My Personal Article Archive Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kozyrskyj, A. L Articles by Becker, A. B Search for Related Content PubMed PubMed Citation Articles by Kozyrskyj, A. L Articles by Becker, A. B

Increased risk of childhood asthma from antibiotic use in early life

¹Faculty of Pharmacy, University of Manitoba, Winnipeg, Manitoba ²Dept Community Health Sciences, Manitoba Centre for Health Policy, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba ³Dept of Pediatrics and Child Health, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba ⁴Division of Clinical Epidemiology, Royal Victoria Hospital; Faculty of Medicine, McGill University, Montreal, Quebec

kozyrsk{at}cc.umanitoba.ca

Abstract

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 Manitoba, Canada's health care and prescription databases, this longitudinal study assessed the association between antibiotic prescription use during the first year of life and asthma at age 7 in a 1995 birth cohort of 13,116 children.

Results: Independent of well-known asthma risk factors, children receiving antibiotics in the first year of life were significantly more likely to develop asthma at age 7. The association with asthma was observed for antibiotic use in non-respiratory tract infections (adjusted OR=1.86, 95% CI: 1.02-3.37). The risk of asthma was highest in children receiving > 4 courses of antibiotics (adjusted OR=1.46, 95%CI: 1.14-1.88), especially among rural children, and in the absence of maternal asthma or a dog in the birth-year. Broad-spectrum 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 which may be reduced by avoiding use of broad spectrum cephalosporins.

Key Words: Anti-Bacterial Agents • Infant • Asthma • Child

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