Yamamoto-Hanada Kiwako, Yang Limin, Narita Masami, Saito Hirohisa, Ohya Yukihiro
Division of Allergy, Department of Medical Subspecialties, National Center for Child Health and Development, Tokyo, Japan.
Department of Allergy and Immunology, National Research Institute for Child Health and Development, Tokyo, Japan.
Ann Allergy Asthma Immunol. 2017 Jul;119(1):54-58. doi: 10.1016/j.anai.2017.05.013.
In the past few decades, the prevalence of allergic diseases has increased rapidly worldwide. At the same time, the overuse of antibiotics has been observed, especially in Japan.
To elucidate the association of early childhood antibiotic use with allergic diseases in later childhood at 5 years of age.
Relevant data were extracted from the hospital-based birth cohort study, the Tokyo Children's Health, Illness and Development Study. To identify signs of asthma and allergic diseases in children, the International Study of Asthma and Allergies in Childhood questionnaire was used. Logistic regression models were applied to estimate the effect of antibiotic use on outcomes in later life.
Antibiotic exposure in children within the first 2 years of life was associated with current asthma (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.10-2.70), current atopic dermatitis (aOR 1.40, 95% CI 1.01-1.94), and current allergic rhinitis (aOR 1.65, 95% CI 1. 05-2.58) at 5 years of age. Analysis of the associations by type of antibiotics showed that cephem was associated with current asthma (aOR 1.97, 95% CI 1.23-3.16) and current rhinitis (aOR 1.82, 95% CI 1.12-2.93), and macrolide was associated with current atopic dermatitis (aOR 1.58, 95% CI 1.07-2.33).
Our findings suggest that antibiotic use within the first 2 years of life was a risk factor for current asthma, current atopic dermatitis, and current allergic rhinitis in 5-year-old children.
在过去几十年中，过敏性疾病在全球的患病率迅速上升。与此同时，人们观察到抗生素的过度使用现象，尤其是在日本。
阐明儿童早期使用抗生素与5岁时儿童后期过敏性疾病之间的关联。
从基于医院的出生队列研究“东京儿童健康、疾病与发育研究”中提取相关数据。为识别儿童哮喘和过敏性疾病的体征，使用了儿童哮喘和过敏国际研究问卷。应用逻辑回归模型来估计抗生素使用对后期生活结局的影响。
1岁以内儿童接触抗生素与5岁时的现患哮喘（调整优势比[aOR] 1.72，95%置信区间[CI] 1.10 - 2.70）、现患特应性皮炎（aOR 1.40，95% CI 1.01 - 1.94）和现患过敏性鼻炎（aOR 1.65，95% CI 1.05 - 2.58）相关。按抗生素类型分析关联表明，头孢菌素与现患哮喘（aOR 1.97，95% CI 1.23 - 3.16）和现患鼻炎（aOR 1.82，95% CI 1.12 - 2.93）相关，大环内酯类与现患特应性皮炎（aOR 1.58，95% CI 1.07 - 2.33）相关。
我们的研究结果表明，1岁以内使用抗生素是5岁儿童现患哮喘、现患特应性皮炎和现患过敏性鼻炎的一个危险因素。
