Neonatal antibiotic treatment is a risk factor for early wheezing.

• OBJECTIVE: The use of antibiotics in infancy and subsequent changes in the intestinal bacterial flora have been discussed as risk factors for the development of asthma. However, it has been difficult to exclude the possibility that antibiotics have been given in early episodes of wheezing. As a result, there has been a risk of reverse causation. To minimize the risk of reverse causation, we have focused on the effect of antibiotics that are already administered on the neonatal ward. METHODS: In a cohort study of infants born in western Sweden in 2003, we studied the development of wheezing. The families of the infants were randomly selected and sent a questionnaire at child ages 6 and 12 months. The response rate was 68.5% to the 6-month questionnaire and 68.9% to the 12-month questionnaire. RESULTS: At 12 months, 20.2% of infants had had 1 or more episodes of wheezing, and 5.3% had had 3 or more episodes. Inhaled corticosteroids had been taken by 4.1% of the infants. Independent risk factors for wheezing disorder treated with inhaled corticosteroids were neonatal antibiotic treatment, male gender, gestational age of <37 weeks, having a mother with asthma, having a sibling with asthma or eczema, and breastfeeding for <5 months. CONCLUSIONS: Treatment with antibiotics in the neonatal period was an independent risk factor for wheezing that was treated with inhaled corticosteroids at 12 months of age. These results indirectly support the hypothesis that an alteration in the intestinal flora can increase the risk of subsequent wheezing.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

Administration

Inhalation

Adrenal Cortex Hormones

therapeutic use

Age Factors

Age of Onset

Analysis of Variance

Anti-Bacterial Agents

adverse effects

therapeutic use

Asthma

chemically induced

drug therapy

epidemiology

Bronchopulmonary Dysplasia

diagnosis

drug therapy

Cohort Studies

Confidence Intervals

Female

Follow-Up Studies

Humans

Incidence

Infant

Infant

Newborn

Male

Odds Ratio

Probability

Questionnaires

Respiratory Sounds

physiopathology

Retrospective Studies

Risk Factors

Severity of Illness Index

Sweden

epidemiology

Sweden

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)