Article Text

Download PDFPDF
Early prescriptions of antibiotics and the risk of allergic disease in adults: a cohort study
  1. P Cullinan,
  2. J Harris,
  3. P Mills,
  4. S Moffat,
  5. C White,
  6. J Figg,
  7. A Moon,
  8. A J Newman Taylor
  1. Department of Occupational and Environmental Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, London, UK
  1. Correspondence to:
    Dr P Cullinan
    Department of Occupational and Environmental Medicine, Imperial College School of Medicine at the National Heart and Lung Institute, Manresa Road, London SW3 6LR, UK; p.cullinanic.ac.uk

Abstract

Background: It is frequently asserted that antibiotic prescriptions in childhood are associated with the development of allergic disease, especially asthma. A study was undertaken to establish the direction of this relationship.

Methods: A retrospective cohort study of 746 adults was performed in three general practices. Antibiotic prescriptions in the first 5years of life, collected from contemporary medical records, were related to self-reports of asthma and hay fever and the results of skin prick testing with common aeroallergens.

Results: There was no relationship between early antibiotic prescription and atopy, either for all antibiotic use (OR 1.01) or for antibiotics prescribed at different ages. The significant associations between prescriptions at ages 4 and 5 and hay fever (OR 1.23 and 1.16, respectively) were explained by coexisting asthma. Relationships between antibiotic use and asthma (allergic or otherwise) were statistically significant and strengthened with increasing age of prescription, but were largely confined to antibiotics prescribed for lower respiratory symptoms.

Conclusions: The reported associations between childhood antibiotic use and asthma are most plausibly explained by “reverse causation”—the tendency for prescriptions to be written for the early manifestations of pre-existing asthma.

  • asthma
  • atopy
  • hay fever
  • antibiotics

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

Footnotes