Neonatal antibiotic treatment is a risk factor for early wheezing.
Journal article, 2008
OBJECTIVE: The use of antibiotics in infancy and subsequent changes in the intestinal bacterial flora have been discussed as risk factors for the development of asthma. However, it has been difficult to exclude the possibility that antibiotics have been given in early episodes of wheezing. As a result, there has been a risk of reverse causation. To minimize the risk of reverse causation, we have focused on the effect of antibiotics that are already administered on the neonatal ward. METHODS: In a cohort study of infants born in western Sweden in 2003, we studied the development of wheezing. The families of the infants were randomly selected and sent a questionnaire at child ages 6 and 12 months. The response rate was 68.5% to the 6-month questionnaire and 68.9% to the 12-month questionnaire. RESULTS: At 12 months, 20.2% of infants had had 1 or more episodes of wheezing, and 5.3% had had 3 or more episodes. Inhaled corticosteroids had been taken by 4.1% of the infants. Independent risk factors for wheezing disorder treated with inhaled corticosteroids were neonatal antibiotic treatment, male gender, gestational age of <37 weeks, having a mother with asthma, having a sibling with asthma or eczema, and breastfeeding for <5 months. CONCLUSIONS: Treatment with antibiotics in the neonatal period was an independent risk factor for wheezing that was treated with inhaled corticosteroids at 12 months of age. These results indirectly support the hypothesis that an alteration in the intestinal flora can increase the risk of subsequent wheezing.
Sweden
Follow-Up Studies
Retrospective Studies
diagnosis
Odds Ratio
Adrenal Cortex Hormones
Male
physiopathology
drug therapy
Risk Factors
drug therapy
Analysis of Variance
Humans
Severity of Illness Index
chemically induced
adverse effects
Infant
Bronchopulmonary Dysplasia
Anti-Bacterial Agents
Incidence
Female
epidemiology
therapeutic use
Inhalation
Questionnaires
Newborn
epidemiology
Administration
Confidence Intervals
Probability
Cohort Studies
Asthma
Age of Onset
Infant
therapeutic use
Respiratory Sounds
Age Factors
Author
Bernt Alm
University of Gothenburg
Laslo Erdes
Per Möllborg
Rolf Pettersson
Gunnar Norvenius
University of Gothenburg
Nils Åberg
University of Gothenburg
Göran Wennergren
University of Gothenburg
Pediatrics
1098-4275 (ISSN)
Vol. 121 4 697-702Subject Categories
Pediatrics
DOI
10.1542/peds.2007-1232
PubMed
18381533