Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Kaohsiung, Taiwan.
Division of Nephrology, Department of Internal Medicine, Kaohsiung Armed Forces General Hospital, Kaohsiung, Taiwan.
Sci Rep. 2021 Apr 19;11(1):8526. doi: 10.1038/s41598-021-87981-7.
Early-life antibiotic use is associated with allergic diseases. The risk factors for the progression from atopic dermatitis (AD) to asthma or allergic rhinitis are still unknown. We aimed to investigate the association between exposure to different antibiotics and the risk of new-onset asthma in children with AD. By using the Longitudinal Health Insurance Database 2005, we selected AD patients less than 6 years old identified by ICD-9-CM code 691.8. The case group was defined as those having new-onset asthma, and the control group was defined as those without an asthma history. Information on antibiotic exposure in the 5 years prior to the index date was collected from drug prescription records. We estimated the adjusted odds ratio by using conditional logistic regression, adjusted for age, sex, index year, other potential risk factors and antibiotics. Antibiotic exposure was associated with the development of asthma in patients with AD (aOR = 3.68, 95% CI 2.13-6.36), particularly for patients less than 5 years old (aOR = 4.14, 95% CI 2.24-7.64) (p for trend < 0.001), even though lower cumulative antibiotic defined daily doses (DDDs) were associated with new-onset asthma occurrence. Antibiotic exposure, especially macrolide exposure, is associated with an increased risk of asthma in patients with AD.
早期使用抗生素与过敏疾病有关。从特应性皮炎（AD）进展为哮喘或过敏性鼻炎的危险因素尚不清楚。我们旨在研究暴露于不同抗生素与 AD 儿童新发哮喘风险之间的关联。通过使用 2005 年纵向健康保险数据库，我们选择了由 ICD-9-CM 代码 691.8 识别的年龄小于 6 岁的 AD 患者。病例组定义为新发哮喘患者，对照组定义为无哮喘病史患者。从药物处方记录中收集了索引日期前 5 年内抗生素暴露的信息。我们使用条件逻辑回归估计了调整后的优势比，调整了年龄、性别、索引年、其他潜在危险因素和抗生素。抗生素暴露与 AD 患者哮喘的发展有关（aOR=3.68，95%CI 2.13-6.36），特别是对于年龄小于 5 岁的患者（aOR=4.14，95%CI 2.24-7.64）（p趋势<0.001），尽管较低的累积抗生素定义日剂量（DDD）与新发哮喘的发生有关。抗生素暴露，特别是大环内酯类抗生素暴露，与 AD 患者哮喘风险增加相关。
