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Lack of Association between Antibiotic Use in the First Year of Life and Asthma, Allergic Rhinitis, or Eczema at Age 5 Years

Channing Laboratory, Department of Medicine, Brigham and Women's Hospital; Division of Pulmonary and Critical Care Medicine, Beth Israel Deaconess Medical Center; Harvard Medical School; Harvard School of Public Health; and Dana-Farber Cancer Institute, Boston, Massachusetts

Correspondence and requests for reprints should be addressed to Juan C. Celedón, M.D., Dr.P.H., Channing Laboratory, 181 Longwood Avenue, Boston, MA 02115. E-mail: juan.celedon{at}channing.harvard.edu

ABSTRACT

Five retrospective studies have reported an association between antibiotic use in early life and asthma in childhood. We studied the relationship between the use of oral antibiotics in the first year of life and asthma, allergic rhinitis, and eczema at age 5 years among 448 children with a parental history of atopy monitored from birth. After adjustment for potential confounders, we found no significant association between antibiotic use in the first year of life and asthma (odds ratio [OR] for one versus no courses of antibiotics, 0.5; 95% confidence interval [CI] for OR, 0.2 to 1.5; OR for two or more versus no courses of antibiotics, 1.0; 95% CI for OR, 0.5 to 2.2), recurrent wheezing, allergic rhinitis, or eczema at age 5 years. There was no significant association between antibiotic use in the first year of life and having at least one of three atopic diseases (asthma, allergic rhinitis, or eczema) at age 5 years (OR for one versus no courses of antibiotics, 0.7; 95% CI, 0.4 to 1.4; OR for two or more versus no courses of antibiotics, 0.9; 95% CI, 0.5 to 1.4). Our findings do not support the hypothesis that antibiotic use in early life is associated with the subsequent development of asthma and atopy in childhood.

Key Words: antibiotic use • asthma • early life

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