Allergy Asthma Immunol Res.  2018 Sep;10(5):457-465. 10.4168/aair.2018.10.5.457.

Effects of Antibiotics on the Development of Asthma and Other Allergic Diseases in Children and Adolescents

Affiliations
  • 1Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. kshent@catholic.ac.kr
  • 2Department of Biostatistics, The Catholic University of Korea, Seoul, Korea.

Abstract

PURPOSE
Our aim was to explore whether antibiotic exposure in children and adolescents is associated with the later development of allergic diseases, using nationwide population-based claims data.
METHODS
We collected information from the National Health Insurance Service (2006-2015) database. A total of 5,626,328 children and adolescents were eligible for the study. We explored whether exposure to antibiotics over the prior 7 years affects the later development of allergic diseases. We ran 3 analytical models after adjusting for confounding factors including age, sex, the number of visits to healthcare providers, income, and the place of residence (urban/rural).
RESULTS
Allergic diseases were most common in male children and those aged < 10 years (atopic dermatitis, asthma and allergic rhinitis; all P < 0.01). Also, urban residents with higher incomes were more likely to develop allergic diseases (all P < 0.01). The annual number of days on which antibiotics were prescribed differed significantly between subjects with each allergic disease studied and a comparison group (all P < 0.01). Multiple logistic regression showed that as the duration of antibiotic exposure increased, the incidences of atopic dermatitis, asthma, and allergic rhinitis trended upward, even after adjusting for confounding factors (P for trend < 0.01).
CONCLUSIONS
Antibiotic use early in life is associated with an increased risk of allergic disease, especially in young children; the risk increases as the duration of antibiotic therapy rises. Moreover, urban residence was more strongly associated with a longer duration of antibiotic use than was rural residence.

Keyword

Asthma; atopic dermatitis; allergic rhinitis; antibiotics; epidemiologic

MeSH Terms

Adolescent*
Anti-Bacterial Agents*
Asthma*
Child*
Dermatitis
Dermatitis, Atopic
Health Personnel
Humans
Incidence
Logistic Models
Male
National Health Programs
Rhinitis, Allergic
Anti-Bacterial Agents

Figure

  • Figure The odds ratios of developing allergic disease by the duration of exposure to antibiotics. The odds ratios reflect the risks in deciles compared with the average risk in the comparison group. The error bars reflect the standard error.


Cited by  2 articles

Can the Use of Antibiotics Alter the Susceptibility to Allergic Diseases?
So-Yeon Lee
Allergy Asthma Immunol Res. 2018;10(5):425-427.    doi: 10.4168/aair.2018.10.5.425.

Associated Factors for Asthma Severity in Korean Children: A Korean Childhood Asthma Study
Eun Lee, Dae Jin Song, Woo Kyung Kim, Dong In Suh, Hey-Sung Baek, Meeyong Shin, Young Yoo, Jin Tack Kim, Ji-Won Kwon, Gwang Cheon Jang, Dae Hyun Lim, Hyeon-Jong Yang, Hwan Soo Kim, Ju-Hee Seo, Sung-Il Woo, Hyung Young Kim, Youn Ho Shin, Ju Suk Lee, Jisun Yoon, Sungsu Jung, Minkyu Han, Eunjin Eom, Jinho Yu
Allergy Asthma Immunol Res. 2020;12(1):86-98.    doi: 10.4168/aair.2020.12.1.86.


Reference

1. Spergel JM, Paller AS. Atopic dermatitis and the atopic march. J Allergy Clin Immunol. 2003; 112:Suppl. S118–S127.
Article
2. Laughter D, Istvan JA, Tofte SJ, Hanifin JM. The prevalence of atopic dermatitis in Oregon schoolchildren. J Am Acad Dermatol. 2000; 43:649–655.
Article
3. Yoon J, Choi YJ, Lee E, Cho HJ, Yang SI, Kim YH, et al. Allergic rhinitis in preschool children and the clinical utility of FeNO. Allergy Asthma Immunol Res. 2017; 9:314–321.
Article
4. Kay J, Gawkrodger DJ, Mortimer MJ, Jaron AG. The prevalence of childhood atopic eczema in a general population. J Am Acad Dermatol. 1994; 30:35–39.
Article
5. Gustafsson D, Sjöberg O, Foucard T. Development of allergies and asthma in infants and young children with atopic dermatitis--a prospective follow-up to 7 years of age. Allergy. 2000; 55:240–245.
6. Rhodes HL, Thomas P, Sporik R, Holgate ST, Cogswell JJ. A birth cohort study of subjects at risk of atopy: twenty-two-year follow-up of wheeze and atopic status. Am J Respir Crit Care Med. 2002; 165:176–180.
7. Asher MI, Montefort S, Björkstén B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC Phases One and Three repeat multicountry cross-sectional surveys. Lancet. 2006; 368:733–743.
Article
8. Kim DH, Han K, Kim SW. Relationship between allergic rhinitis and mental health in the general Korean adult population. Allergy Asthma Immunol Res. 2016; 8:49–54.
Article
9. Platts-Mills TA. The allergy epidemics: 1870–2010. J Allergy Clin Immunol. 2015; 136:3–13.
Article
10. Okada H, Kuhn C, Feillet H, Bach JF. The ‘hygiene hypothesis’ for autoimmune and allergic diseases: an update. Clin Exp Immunol. 2010; 160:1–9.
Article
11. Strachan DP. Hay fever, hygiene, and household size. BMJ. 1989; 299:1259–1260.
Article
12. Liu AH. Revisiting the hygiene hypothesis for allergy and asthma. J Allergy Clin Immunol. 2015; 136:860–865.
Article
13. Stiemsma LT, Reynolds LA, Turvey SE, Finlay BB. The hygiene hypothesis: current perspectives and future therapies. ImmunoTargets Ther. 2015; 4:143–157.
Article
14. Castro-Nallar E, Shen Y, Freishtat RJ, Pérez-Losada M, Manimaran S, Liu G, et al. Integrating microbial and host transcriptomics to characterize asthma-associated microbial communities. BMC Med Genomics. 2015; 8:50.
Article
15. Penders J, Stobberingh EE, van den Brandt PA, Thijs C. The role of the intestinal microbiota in the development of atopic disorders. Allergy. 2007; 62:1223–1236.
Article
16. Farooqi IS, Hopkin JM. Early childhood infection and atopic disorder. Thorax. 1998; 53:927–932.
Article
17. Russell SL, Gold MJ, Hartmann M, Willing BP, Thorson L, Wlodarska M, et al. Early life antibiotic-driven changes in microbiota enhance susceptibility to allergic asthma. EMBO Rep. 2012; 13:440–447.
Article
18. Wickens K, Pearce N, Crane J, Beasley R. Antibiotic use in early childhood and the development of asthma. Clin Exp Allergy. 1999; 29:766–771.
Article
19. Park SJ, Choi NK, Park KH, Woo SJ. Nationwide incidence of clinically diagnosed retinal vein occlusion in Korea, 2008 through 2011: preponderance of women and the impact of aging. Ophthalmology. 2014; 121:1274–1280.
20. Kim S, Kim J, Park SY, Um HY, Kim K, Kim Y, et al. Effect of pregnancy in asthma on health care use and perinatal outcomes. J Allergy Clin Immunol. 2015; 136:1215–1236.e1-6.
Article
21. Park SJ, Kwon KE, Choi NK, Park KH, Woo SJ. Prevalence and incidence of exudative age-related macular degeneration in South Korea: a nationwide population-based study. Ophthalmology. 2015; 122:2063–2070.e1.
22. Kim BK, Kim JY, Kang MK, Yang MS, Park HW, Min KU, et al. Allergies are still on the rise? A 6-year nationwide population-based study in Korea. Allergol Int. 2016; 65:186–191.
Article
23. Kim M, Choi KH, Hwang SW, Lee YB, Park HJ, Bae JM. Inflammatory bowel disease is associated with an increased risk of inflammatory skin diseases: a population-based cross-sectional study. J Am Acad Dermatol. 2017; 76:40–48.
Article
24. Gilbert JA, Quinn RA, Debelius J, Xu ZZ, Morton J, Garg N, et al. Microbiome-wide association studies link dynamic microbial consortia to disease. Nature. 2016; 535:94–103.
Article
25. Björkstén B, Naaber P, Sepp E, Mikelsaar M. The intestinal microflora in allergic Estonian and Swedish 2-year-old children. Clin Exp Allergy. 1999; 29:342–346.
Article
26. Gensollen T, Iyer SS, Kasper DL, Blumberg RS. How colonization by microbiota in early life shapes the immune system. Science. 2016; 352:539–544.
Article
27. Prescott SL, Macaubas C, Smallacombe T, Holt BJ, Sly PD, Holt PG. Development of allergen-specific T-cell memory in atopic and normal children. Lancet. 1999; 353:196–200.
Article
28. Romagnani S. Human TH1 and TH2 subsets: regulation of differentiation and role in protection and immunopathology. Int Arch Allergy Immunol. 1992; 98:279–285.
Article
29. Lynch SV, Wood RA, Boushey H, Bacharier LB, Bloomberg GR, Kattan M, et al. Effects of early-life exposure to allergens and bacteria on recurrent wheeze and atopy in urban children. J Allergy Clin Immunol. 2014; 134:593–601.e12.
30. Valkonen M, Wouters IM, Täubel M, Rintala H, Lenters V, Vasara R, et al. Bacterial exposures and associations with atopy and asthma in children. PLoS One. 2015; 10:e0131594.
Article
31. Hoskin-Parr L, Teyhan A, Blocker A, Henderson AJ. Antibiotic exposure in the first two years of life and development of asthma and other allergic diseases by 7.5 yr: a dose-dependent relationship. Pediatr Allergy Immunol. 2013; 24:762–771.
Article
32. Chung KF. Airway microbial dysbiosis in asthmatic patients: A target for prevention and treatment? J Allergy Clin Immunol. 2017; 139:1071–1081.
Full Text Links
  • AAIR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr