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Effect of antibiotic use for acute bronchiolitis on new-onset asthma in children

I-Lun Chen1,2, Hsin-Chun Huang1, Yu-Han Chang3

  • 1Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung City, Taiwan.

Scientific Reports
|April 19, 2018
PubMed

Insights

Early antibiotic use for bronchiolitis increases new-onset asthma risk in children. Macrolides, particularly azithromycin, showed the strongest association with asthma development.

Area of Science:

  • Pediatric Medicine
  • Pharmacology
  • Epidemiology

Background:

  • Early-life antibiotic exposure is linked to asthma development.
  • Bronchiolitis is a common early-life respiratory infection often treated with antibiotics.

Purpose of the Study:

  • To investigate the association between antibiotic use for early-life bronchiolitis and the subsequent development of new-onset asthma in children.
  • To identify specific antibiotic classes or agents that may increase asthma risk.

Main Methods:

  • Retrospective cohort study using Taiwan's National Health Insurance Research Database (2005-2010).
  • International Classification of Disease (ICD) codes used for diagnosis.
  • Conditional logistic regression analysis adjusted for age, sex, atopy, NSAID use, and antibiotic timing.
  • Asthma diagnosis confirmed by ICD criteria and medication use.

Main Results:

  • High-dose antibiotic use for bronchiolitis was significantly associated with increased asthma risk (aOR=3.33, 95% CI=2.67-4.15).
  • Macrolide antibiotics, especially azithromycin, demonstrated the strongest association with new-onset asthma (Macrolides aOR=2.87, 95% CI=1.99-4.16; Azithromycin aOR=3.45, 95% CI=1.62-7.36).

Conclusions:

  • Antibiotic treatment for early-life bronchiolitis, particularly high-dose macrolides like azithromycin, is associated with an elevated risk of developing asthma.
  • These findings highlight the importance of judicious antibiotic prescribing in infants and young children to potentially mitigate long-term respiratory health risks.

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