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

• Kim DH
• Han K
• Kim SW

• KMID: 2418044
• DOI: http://doi.org/10.4168/aair.2018.10.5.457

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.

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