Early antibiotic exposure may predispose infants to childhood asthma
Antibiotic use during infancy may increase the risk of developing childhood asthma in a dose-dependent fashion, a study has found.
Researchers examined a cohort of 152,622 children enrolled in the Tennessee Medicaid Program, every one of whom were singletons, born at term and had birthweight above the low threshold. They obtained data on infant antibiotic exposure and childhood asthma diagnosis from prescription fills and healthcare encounter claims.
In the cohort, 79 percent of the children had at least one antibiotic prescription fill during infancy (median age at the first fill, 229 days). Most prescribed antibiotics were narrow spectrum (67.6 percent), of oral formulation (96.8 percent) and had anaerobic activity (83.5 percent). Penicillin was the most commonly prescribed class of antibiotics (68.1 percent), with amoxicillin being the single most frequently given (52.8 percent).
Multivariable logistic regression models showed that infant antibiotic use was associated with increased likelihood of developing childhood asthma in a dose-dependent manner. Specifically, the odds increased by 20 percent for each additional antibiotic prescription filled (adjusted odds ratio [aOR], 1.20, 95 percent CI, 1.19–1.20). This significant dose-dependent relationship persisted after additionally controlling for timing and type of antibiotics.
Furthermore, broad-spectrum only antibiotic fills were associated with greater odds of developing asthma compared with narrow-spectrum only fills (aOR, 1.10, 1.05–1.19). There was no significant relationship between timing, formulation, anaerobic coverage, and class of antibiotics and childhood asthma.
The findings contribute important insights into specific aspects of infant antibiotic exposure, the researchers said. Physicians should therefore carefully weigh the risks and benefits of antibiotic use in infants before administration, considering possible alternative treatment strategies when available.
Future studies should focus on how the adverse effects of antibiotics could be prevented when their use is required, they added.