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Atopic wheezing and early life antibiotic exposure: a nested case-control study
Mike Thomas1, Adnan Custovic, Ashley Woodcock
1Department of General Practice, University of Aberdeen, Aberdeen, UK.
Summary
Early antibiotic use in infants is linked to increased allergy and asthma risks. Children with recurrent wheeze received more antibiotics in their first year, suggesting a potential causal role.
Area of Science:
- Pediatric Allergy and Immunology
- Microbiome Research
- Environmental Health
Background:
- Rising prevalence of allergic sensitization and asthma in children.
- Potential role of early-life exposures, including antibiotic use, in immune system development.
Purpose of the Study:
- To investigate the association between early-life antibiotic exposure and allergic sensitization with recurrent wheeze in young children.
- To compare antibiotic prescription patterns in sensitized children with wheeze versus non-sensitized controls.
Main Methods:
- Nested case-control study within a population-based birth cohort.
- Comparison of antibiotic prescriptions (timing, type, indication) in the first three years of life.
- Matching of cases (sensitized, recurrent wheeze) and controls (non-sensitized, no wheeze) for key demographic and environmental factors.
Main Results:
- Higher proportion of cases received antibiotics in the first year of life (92% vs. 70%, p=0.04).
- Shorter median time to first antibiotic course for cases (6 vs. 8 months, p=0.03).
- Significantly more antibiotic courses for lower respiratory tract infections in cases over three years (p=0.007).
Conclusions:
- Early-life antibiotic exposure, particularly in the first year, is associated with allergic sensitization and recurrent wheeze.
- Data support a potential causative role for early broad-spectrum antibiotic use in the development of childhood asthma and allergies.