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儿童早期抗生素暴露与儿童哮喘的发展

Antibiotic exposure in early life and development of childhood asthma.

作者信息

Dewan Nikhil, Goldman Ran D

出版信息

Can Fam Physician. 2020 Sep;66(9):661-663.

Abstract

I understand that antibiotic use in children younger than 2 years of age has been associated with the development of asthma. With so many children in early life suffering from middle ear and throat infections, are those children who are treated with antibiotics at higher risk of developing asthma or exacerbating their asthma? Is there a relationship between number of antibiotic courses and risk of asthma? Administration of antibiotics in the first 2 years of life has been shown to be associated with asthma later in life in retrospective and prospective studies. However, study limitations such as protopathic bias, poor data collection methods, and small cohort size prevent clear determination of causality between antibiotics and asthma. The use of antibiotics in young children warrants careful consideration due to antibiotic resistance, adverse effects, and potential association with asthma.

摘要

我了解,2岁以下儿童使用抗生素与哮喘的发生有关。由于早年有如此多儿童患有中耳和咽喉感染,那些接受抗生素治疗的儿童患哮喘或使哮喘加重的风险更高吗?抗生素疗程数量与哮喘风险之间有关系吗?回顾性和前瞻性研究均表明,生命最初2年使用抗生素与日后患哮喘有关。然而,诸如原发病偏倚、数据收集方法不佳和队列规模较小等研究局限性,妨碍了明确确定抗生素与哮喘之间的因果关系。鉴于抗生素耐药性、不良反应以及与哮喘的潜在关联,幼儿使用抗生素值得慎重考虑。

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本文引用的文献

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Does lung microbiome play a causal or casual role in asthma?肺部微生物组在哮喘中起因果作用还是偶然作用?
Pediatr Pulmonol. 2018 Oct;53(10):1340-1345. doi: 10.1002/ppul.24086. Epub 2018 Jun 26.
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The relationship of early-life antibiotic use with asthma in at-risk children.高危儿童早期使用抗生素与哮喘的关系。
J Allergy Clin Immunol. 2014 Sep;134(3):728-9. doi: 10.1016/j.jaci.2014.05.006. Epub 2014 Jun 19.

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