No link between early antibiotic exposure and later asthma or lung dysfunction

  • Chest

  • International Clinical Digest
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Takeaway

  • A long-term prospective cohort study has found no association between increasing exposure to antibiotics up to age 2 years in children with a family history of allergy (and genotyping for mutations in the glutathione S-transferase [GST] superfamily genes) and subsequent development of impaired lung function or asthma at ages 12 and 18 years.

Why this matters

  • First study to explore the link under the hypothesis that early antibiotic exposure alters the gut microbiome, disturbing normal colonization of intestinal microflora and delaying postnatal maturation of T helper cells.
  • Antibiotic exposure to infants should be minimised, but there is no evidence of a relationship to development of compromised lung function or asthma.

Study design

  • Prospective cohort of parent-report childhood antibiotic use (birth-2 years) in 620 infants with a family history of asthma, allergic rhinitis, eczema, or severe food allergy.
  • Participants were genotyped for polymorphisms in GST-P, GST-M, GST-T.
  • Funding: Nestec Ltd; Asthma Foundation of Victoria; National Health and Medical Research Council of Australia.

Key results

  • No association between increasing days of early antibiotic exposure and reduced forced expiratory volume in 1 second or forced vital capacity or asthma at age 18 years
  • No evidence linking GST-risk polymorphisms or specific types of antibiotics to later lung function deficits.

Limitations

  • Observational design.
  • Reliance on parent reports of antibiotic type and duration.