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Published on: August 7, 2017
Antibiotic Use in Early Life, Rural Residence, and Allergic Diseases in Argentinean Children
Yueh-Ying Han1, Erick Forno1, Héctor A Badellino2
1Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
Insights
Early antibiotic use is linked to childhood wheeze and allergic rhinoconjunctivitis in urban Argentinean children. Living in a rural environment during infancy may offer protection against these antibiotic-related atopic diseases.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Epidemiology
Background:
- Limited understanding of how urban vs. rural settings influence antibiotic effects on childhood allergies.
- Investigating the role of early-life antibiotic exposure in the development of allergic diseases.
Purpose of the Study:
- To determine if living environment in the first year of life modifies the association between early antibiotic use and childhood allergic diseases.
- Examining the impact of urban versus rural residence on antibiotic-associated allergic outcomes.
Main Methods:
- Cross-sectional study of 1517 children (ages 6-7) in urban and rural Argentina.
- Validated International Study of Asthma and Allergies in Childhood questionnaire used for allergic disease assessment.
- Multivariate logistic regression analyzed antibiotic use and allergic disease relationships.
Main Results:
- Early antibiotic use correlated with increased odds of current wheeze (OR 1.8) and allergic rhinoconjunctivitis (OR 1.9).
- In urban dwellers, antibiotic use significantly increased odds of wheeze (OR 2.4) and allergic rhinoconjunctivitis (OR 2.1).
- No significant association was found between early antibiotic use and these conditions in children residing in rural areas during their first year.
Conclusions:
- Early-life antibiotic exposure is associated with wheeze and allergic rhinoconjunctivitis in children with urban early-life residence.
- Rural early-life exposure may mitigate adverse effects of antibiotics on childhood atopic diseases.
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.
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