Neonatal antibiotic treatment is a risk factor for early wheezing.
Artikel i vetenskaplig tidskrift, 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

Författare

Bernt Alm

Göteborgs universitet

Laslo Erdes

Per Möllborg

Rolf Pettersson

Gunnar Norvenius

Göteborgs universitet

Nils Åberg

Göteborgs universitet

Göran Wennergren

Göteborgs universitet

Pediatrics

1098-4275 (ISSN)

Vol. 121 4 697-702

Ämneskategorier

Pediatrik

DOI

10.1542/peds.2007-1232

PubMed

18381533