Antibiotics in Infancy-Risk Factor for Childhood Asthma

Project: Research project

Project Details


(Provided by Applicant) Morbidity and mortality from childhood asthma have
been increasing in all developed countries over the past three decades,
including in the United States. Numerous theories have been advanced to
explain this asthma epidemic, but no single theory has held up to careful
scrutiny. Recent international studies have suggested a relatively strong
causal relationship between increased risk of childhood asthma and exposure to
antibiotics during childhood, especially during the first year of life. The
increased asthma risk was seen whether antibiotics were used to treat
respiratory or non-respiratory infections. While these previous studies are
suggestive, there are significant methodologic concerns about each study. A
major concern with most of the studies is their reliance on retrospective
recall of antibiotic exposure data from parents years after the exposure. We
have data from a prospective, NIH-funded study of the relationship between
early environmental exposures and the development of asthma in a birth cohort
of children followed to an average 6.7 years of age. At 6.7 years, 482 (58%)
of the original 833 children were clinically examined as part of this
Childhood Asthma Study (CAS). In addition to clinical histories, the 6- to 7-
year clinical examination included skin tests, IgE antibody tests, pulmonary
function tests and methacholine challenge. At entry all of the CAS children
were within the Health Alliance Plan (HAP) HMO. The current proposal is based
on combining the CAS data set with pharmacy data extracted from the HAP data
archives. This will allow us to examine possible relationships between
antibiotic use, as determined by prescriptions filled, and asthma at 6 to 7
years of age. While not strictly a prospective study, these methods will
avoid many of the potential sources of bias found in previous studies. We
will also be able to evaluate any relationships between antibiotic exposure
and asthma for confounding by other risk factors such as bedroom allergen
levels, pet ownership, cigarette smoke exposure, and parental history of
asthma or allergy. The proposed study is entirely separate from the goals of
the original grant which did not consider antibiotic use as a potential risk
factor for asthma or allergy. This new analysis will allow a much more
rigorous examination of the possible relationship between early antibiotic use
and asthma in a population of American children.
StatusNot started


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