Volume 40, Issue 8 p. 1230-1237

ORIGINAL ARTICLE/Epidemiology of Allergic Disease

Antibiotic use in early life and development of allergic diseases: respiratory infection as the explanation

X.-M. Mai,

X.-M. Mai

Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

Department of Preventive Health Care, SINTEF, Trondheim, Norway

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I. Kull,

I. Kull

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden

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M. Wickman,

M. Wickman

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Department of Paediatrics, Sachs' Children's Hospital, Stockholm, Sweden

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A. Bergström,

A. Bergström

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

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X.-M. Mai,

X.-M. Mai

Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway

Department of Preventive Health Care, SINTEF, Trondheim, Norway

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I. Kull,

I. Kull

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden

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M. Wickman,

M. Wickman

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

Department of Paediatrics, Sachs' Children's Hospital, Stockholm, Sweden

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A. Bergström,

A. Bergström

Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden

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First published: 07 July 2010

https://doi.org/10.1111/j.1365-2222.2010.03532.x

Citations: 57

Correspondence:
Xiao-Mei Mai, Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, 7489 Trondheim, Norway.
E-mail: [email protected]

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Summary

Background Early antibiotic use has been postulated to increase the development of allergic disease. Antibiotic use results from infection. Early infection may play a confounding role in the relationship between antibiotic use and allergic disease.

Objective We aimed to investigate the relationship between antibiotic use during the first year of life and the development of allergic diseases in a birth cohort study, and also to carefully address the confounding effect of early respiratory infection.

Methods Three thousand three hundred and six children were included in this study who participated in investigations at all occasions of 2 months, 1, 4 and 8 years of age. Data on antibiotic use and respiratory infections were collected at the age of 1 year. Diagnoses of allergic diseases at 4 and 8 years of age were derived from the follow-up questionnaires.

Results During the first year of life, 43% (n=1420) of the children received antibiotics and 32% (n=1046) of the children had at least one type of respiratory infection among pneumonia, bronchitis and otitis. In univariate logistic regression analysis and after adjustment for early life factors, antibiotic use during the first year of life was associated with wheeze, asthma, eczema and food hypersensitivity at 4 years of age. After adjustment for the above respiratory infections during the first year of life, only the associations with wheeze and asthma at age 4 years remained statistically significant. These associations became non-significant in a subgroup analysis in children without early allergic signs. At age 8 years, antibiotic use during the first year of life was significantly associated with wheeze and eczema after adjustment for early life factors. The significant associations at age 8 years faded away following further adjustment for the respiratory infections.

Conclusion Our study indicated that the association between early antibiotic use and later allergic disease could at least partially be explained by early respiratory infection.

Cite this as: X.-M. Mai, I. Kull, M. Wickman and A. Bergström, Clinical & Experimental Allergy, 2010 (40) 1230–1237.

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Volume40, Issue8

August 2010

Pages 1230-1237

Antibiotic use in early life and development of allergic diseases: respiratory infection as the explanation

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Antibiotic use in early life and development of allergic diseases: respiratory infection as the explanation

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