Arizona Respiratory Center, College of Public Health, Department of Pharmacology, University of Arizona, Tucson, AZ 85724, USA.
Clin Exp Allergy. 2010 Aug;40(8):1222-9. doi: 10.1111/j.1365-2222.2010.03539.x. Epub 2010 Jun 7.
Findings from studies of the relation between early antibiotic use and subsequent asthma have been inconsistent, which may be attributable to methodologic issues.
Our objective was to assess the impact of confounding by indication on the relation of early antibiotic use to childhood asthma through age 5 in a non-selected birth cohort (n=424).
Oral antibiotic use was assessed by frequent nurse interviews in the first 9 months of life. Physician-diagnosed active asthma and eczema were assessed by questionnaire at 1, 2, 3, and 5 years, and were considered as ever asthma or ever eczema if positive at any age. Allergen-specific IgE was assessed in plasma at 1, 2, 3, and 5 years. Confounding by indication was investigated by considering the relation of asthma to antibiotic use while controlling for the number of illness visits to a physician in early life.
There was no statistically significant relation of early antibiotic use with physician-diagnosed eczema or allergen-specific IgE. A dose-response relation was evident for antibiotic use with ever asthma (odds ratio [OR]=1.5, P=0.047). Ever asthma also increased significantly with the number of illness visits to a physician (P<0.001). After adjustment for number of illness visits, antibiotic use showed no relation with asthma.
The relation of asthma to antibiotics in this cohort appears to be an artefact of the strong relation of number of physician visits for illness with both antibiotic use and risk for asthma.
早期使用抗生素与随后发生哮喘之间关系的研究结果并不一致，这可能归因于方法学问题。
我们的目的是通过非选择性出生队列（n=424）评估指示性混杂对早期抗生素使用与 5 岁以下儿童哮喘之间关系的影响。
通过在生命的前 9 个月中频繁的护士访谈评估口服抗生素的使用情况。通过问卷调查在 1、2、3 和 5 岁时评估医生诊断的活动性哮喘和湿疹，并在任何年龄呈阳性时将其视为曾患哮喘或曾患湿疹。在 1、2、3 和 5 岁时评估血浆中的过敏原特异性 IgE。通过考虑哮喘与抗生素使用之间的关系，同时控制生命早期看医生的就诊次数来研究指示性混杂。
早期抗生素使用与医生诊断的湿疹或过敏原特异性 IgE 之间没有统计学上的显著关系。抗生素使用与曾患哮喘之间存在剂量反应关系（比值比[OR]=1.5，P=0.047）。曾患哮喘也与看医生的就诊次数显著增加相关（P<0.001）。在调整就诊次数后，抗生素使用与哮喘之间没有关系。
在该队列中，哮喘与抗生素之间的关系似乎是看医生的就诊次数与抗生素使用和哮喘风险之间的强烈关系的一种人为产物。
