Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
Department of Pediatric Respiratory Medicine, Regional Eastern Clinic, San Francisco, Córdoba, Argentina.
J Allergy Clin Immunol Pract. 2017 Jul-Aug;5(4):1112-1118.e2. doi: 10.1016/j.jaip.2016.12.025. Epub 2017 Feb 4.
Little is known about differential effects of antibiotic use on allergic diseases in rural versus urban environments.
To examine whether area of residence in the first year of life modifies the relation between antibiotic use in early life and allergic diseases during childhood.
Cross-sectional study of allergic diseases in 1517 children (ages 6-7 years) attending 101 schools in urban and rural areas of San Francisco (Córdoba, Argentina). Current asthma, wheeze, and allergic rhinoconjunctivitis were defined on the basis of responses to a validated questionnaire from the International Study of Asthma and Allergies in Childhood. Multivariate logistic regression was used for the analysis of antibiotic use and allergic diseases.
After adjustment for paracetamol use, bronchiolitis, and other covariates, antibiotic use in the first year of life was associated with increased odds of current wheeze (odds ratio [OR], 1.8; 95% CI, 1.3-2.6) and allergic rhinoconjunctivitis (OR, 1.9; 95% CI, 1.3-2.7). After stratification by area of residence, antibiotic use was associated with current wheeze (OR, 2.4; 95% CI, 1.5-4.0) and allergic rhinoconjunctivitis (OR, 2.1; 95% CI, 1.3-3.4) among children who lived in an urban area in their first year of life, but not among those who lived in a rural area in their first year of life.
Early-life antibiotic use is associated with current wheeze and allergic rhinoconjunctivitis in Argentinean children who lived in urban areas during their first year of life. Exposure to a rural environment early in life may protect against the adverse effects of antibiotics on atopic diseases in children.
对于抗生素使用对农村和城市环境中过敏性疾病的影响，知之甚少。
研究生命的第一年居住地区是否会改变生命早期使用抗生素与儿童期过敏性疾病之间的关系。
在阿根廷科尔多瓦市的城市和农村地区的 101 所学校中，对 1517 名（年龄为 6-7 岁）儿童进行了过敏性疾病的横断面研究。根据国际儿童哮喘和过敏研究的验证问卷，确定当前哮喘、喘息和过敏性鼻结膜炎。采用多变量逻辑回归分析抗生素使用与过敏性疾病的关系。
调整对乙酰氨基酚使用、细支气管炎和其他混杂因素后，生命第一年的抗生素使用与当前喘息（比值比[OR]，1.8；95%可信区间[CI]，1.3-2.6）和过敏性鼻结膜炎（OR，1.9；95% CI，1.3-2.7）的几率增加相关。根据居住地区分层后，在生命的第一年居住在城市地区的儿童中，抗生素使用与当前喘息（OR，2.4；95% CI，1.5-4.0）和过敏性鼻结膜炎（OR，2.1；95% CI，1.3-3.4）相关，但在生命的第一年居住在农村地区的儿童中没有相关性。
在生命的第一年居住在城市地区的阿根廷儿童中，生命早期抗生素使用与当前喘息和过敏性鼻结膜炎有关。生命早期接触农村环境可能会保护儿童免受抗生素对特应性疾病的不良影响。
