Researchers found a dose-dependent association between antibiotic use in infancy and the development of asthma in childhood, regardless of the type of antibiotic administered or the timing of the prescription, according to study results published in Clinical Infectious Diseases. The researchers reported that the odds of future asthma diagnoses increased with each additional antibiotic prescription.
“While previous studies have demonstrated an association between antibiotic exposure during infancy and an increased risk for asthma development, a more comprehensive and simultaneous assessment of the impact of specific aspects of antibiotic use is needed to inform clinical guidelines for safe use of antibiotics in infancy,” Pingsheng Wu, PhD, research associate professor of medicine at Vanderbilt University Medical Center, told Infectious Diseases in Children.
The researchers analyzed data on antibiotic prescriptions for more than 150,000 full-term children born between 1995 and 2003 who were enrolled in the Tennessee Medicaid program. All infants were singleton with a normal birth weight and were otherwise healthy.
According to Wu and colleagues, 79% of children had at least one antibiotic prescription filled by age 1 year. The odds of asthma in childhood increased 20% for each additional antibiotic prescription filled (adjusted OR = 1.2; 95% CI, 1.19-1.2).
The researchers wrote that the relationship between antibiotic prescriptions and later asthma diagnosis occurred regardless of the type of antibiotic given or the timing of the antibiotic. However, infants who were prescribed only broad-spectrum antibiotics were more likely to have asthma in childhood compared with infants who were prescribed only narrow-spectrum antibiotics (aOR = 1.1; 95% CI, 1.05-1.19).
Wu and colleagues did not observe significant links between childhood asthma and antibiotic timing, formulation, anaerobic coverage and antibiotic class.
“Antibiotics are the most frequently prescribed medications for children and can be lifesaving for those suffering from severe bacterial infections,” Wu said. “However, antibiotics can negatively impact the diversity and function of the microbiome, increasing the risk for diseases through immune dysregulation and chronic inflammation. In light of the mounting evidence supporting the link between infant antibiotic use and increased risk for childhood asthma, health care providers should critically weigh the risks and benefits of antibiotic use in infants before administration.” – by Katherine Bortz
Disclosures: The authors report no relevant financial disclosures.