Exposure to at least one course of antibiotics in the first year of life may increase the risk of asthma later in childhood, results of a meta-analysis suggest. There may even be a dose-response relationship, with higher risk with each additional course of antibiotics.
The prevalence of asthma in western countries has increased over the last 3 decades, Dr. Carlo A. Marra and colleagues at the University of British Columbia in Vancouver note, which seems to coincide with greater exposure of infants to antibiotics. Nonetheless, epidemiologic evidence linking antibiotic use with asthma risk is conflicting.
To conduct a meta-analysis, Dr. Marra’s group identified seven studies that specifically examined the relationship between receipt of at least one prescription for an antibiotic in the first year of life and the development of physician-diagnosed asthma between the ages of 1 and 18 years.
According to their report in the March issue of Chest, the study cohorts included 12,082 children and 1817 asthma cases.
Overall, the pooled odds ratio was 2 to 1 for asthma risk associated with antibiotic exposure before 1 year of age.
The OR was 1.16 for each additional course of antibiotics taken during the first year of life. Again, there was a trend toward a stronger relationship in the two retrospective studies than in the three prospective studies.
Meanwhile, it is possible to safely reduce the number of antibiotics that infants receive, co-author Dr. Fawziah Marra notes in a press release. Although antibiotics are commonly used to treat upper respiratory tract infections and bronchitis, she notes that most of these infections are viral – for which antibiotics are ineffective. Chest 2006;129:610-618.
Appropriate use of antibiotics is not the issue. It is the overuse of antibiotics and lack of preventative skills at home that are of concern. Remember when mom used to clean the house head to toe after each sniffle to prevent other members in the family from getting sick, but also to prevent the same person from re-infecting themselves. Then there was that cod liver oil and vitamin C tablets before getting on the bus. It’s funny, but my mother never cared if I liked the taste. She only concerned herself with my well-being. Nothing can beat good home DOCTORING!