Researchers warn antibiotics may raise asthma risk in children
ISLAMABAD: Babies who taken even just one course of antibiotics during the first year of their life may face an elevated risk of developing childhood asthma, according to a new Canadian study published in the April issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians (ACCP).
Asthma is a chronic respiratory disease characterized by episodes or attacks of inflammation and narrowing of small airways in response to asthma “triggers.” Asthma attacks can vary from mild to life-threatening and involve shortness of breath, cough, wheezing, chest pain or tightness, or a combination of these symptoms.
The study found those who were exposed to antibiotics in the first year of life were twice as likely as those who were untreated to develop asthma in childhood. In addition, there was a dose-response relationship between the risk and the number of courses of antibiotics.
“Antibiotic use in children has been found to coincide with an increased incidence of childhood asthma,” said lead author Carlo Marra, Pharm D, PhD, University of British Columbia, Vancouver, BC, Canada. “Although the causal nature between antibiotics and asthma is still unclear, our overall results show that treatment with at least one antibiotic as an infant appears to be associated with the development of childhood asthma.”
To examine the association between antibiotic exposure during infancy and the risk of developing childhood asthma, researchers from the University of British Columbia meta-analyzed results of seven studies involving 12,082 children among whom 1,817 cases of childhood asthma were recorded.
Overall, infants exposed to at least one course of antibiotics in the first year were twice as likely as those who were untreated to develop childhood asthma. The effect of antibiotics was more significant in the retrospective studies than the prospective studies.
Researchers also conducted a dose-response analysis of 27,167 children among whom 3,392 asthma cases were documented in five studies.
They found for each additional course of antibiotics taken during the first year of life, the risk increased by 16 percent compared with those who were not exposed to antibiotics. The effect of antibiotics was more significant in retrospective studies than prospective studies.
The antibiotic-asthma association did not seem significant in infants born with high risk factors such as a family history of the condition or a genetic tendency to develop allergies, the study found.
“Asthma is one of the most common chronic childhood diseases, affecting millions of children in the United States,” said W. Michael Alberts, MD, FCCP, President of the American College of Chest Physicians. Asthma is diagnosed in about 30 million people in the US during their lifetime - 22 million adults and 8 million children age 0 to 17 years. In the US, asthma results in about 4,500 deaths every year - about 200 deaths in children.
“By identifying potential risk factors for asthma and educating patients and families about risk factors, we may begin to see a reduction in the overall incidence of asthma,” said Alberts.
The researchers question the rational behind the current recommendation on use of antibiotics in young children. “In children, antibiotics are commonly used to treat ear infections, upper respiratory tract infections, and bronchitis, but not every childhood infection requires an antibiotic,” said the study’s co-author Fawziah Marra, MD, University of British Columbia.
“Current guidelines recommend that children under age 2 receive an antibiotic for diagnosed ear infection. However, the majority of upper respiratory tract infections and bronchitis is viral for which antibiotics are ineffective.”
The use of antibiotics would kill beneficial bacteria in the body and promote growth of molds and or parasites, which in turn make the immune system hyper sensitive to pollen, dust and other harmless substances.
The studies were carried out based on the survey data, not medical records. Because of this, possible errors and bias make the studies used in the meta-analysis less reliable. Although the association was statistically significant, the results of previous studies and the current meta-analysis did not mean use of antibiotics definitely causes asthma.
Further, some cases of asthma may not be identified before antibiotic exposure, which could make the results less reliable, researchers noted.
One possible explanation for the antibiotic-asthma link is that those infants who received antibiotics may be more susceptible to asthma in the first place.