E-drug: Asthma associated with early antibiotic use
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[Intuitively I knew this, and have staunchly kept antibiotics away from
my own kids. But that the association is that clear, is new to me.
Food for thought, and I wonder what E-druggers think of it. Copied
as fair use. HH]
Cure or curse? Giving babies antibiotics makes them more likely to
suffer from asthma
The Economist, October 4th 2003
Everything from air pollution to urine in swimming pools has been
blamed for the dramatic increase in asthma over the last few
decades. It is a vexing problem: since the 1970s, asthma rates in the
developed world have been rising by about 50% a year. What used to
be a relatively rare condition is now troubling some 150m people
worldwide.
Now a team of researchers has shown that being given antibiotics as
a baby seems to play a role in the development of asthma. It is not
the first time that this link has been examined. But this study
distinguishes itself from previous ones by following the children
carefully from birth through to the age of seven, and by making a
point of not relying on parents' mangled memories of when or
whether their rasping, hacking, ear-infected infants took drugs for
their ailments.
Instead, the researchers, led by Dr Christine Cole Johnson, an
epidemiologist at the Henry Ford Hospital in Detroit, were more direct
and less trusting. They called the parents of the 448 young research
subjects by telephone to inquire about their kids' health at the ages of
one and three, and visited them at home at the ages of two and four
(pausing to sample household air and dust). In addition, the
researchers collected details of how many pets roamed about the
house and recorded whether and for how long each child was
breastfed-both touted variously as risk factors and protectors.
They also checked doctors' notes to see if the children had been
prescribed antibiotics. If so, the researchers distinguished between
the so-called "broad spectrum" variety of antibiotics, which includes
penicillin combinations, or the narrower varieties, such as individual
penicillins and macrolides. Finally, when the children reached the age
of seven, the researchers gave them full medical examinations,
keeping an ear out for signs of asthma. Dr Johnson and her
colleagues were specifically interested in what is known as "atopic
asthma", a type of asthma related to allergies.
Half the children had taken oral antibiotics within the first six months
of birth. Dr Johnson found that those who had taken them were over
two and a half times more likely to suffer from asthma later on in
childhood than those who had not. More worryingly, the more courses
of antibiotics taken-and about half of those treated were given several
courses-the greater the risk. The antibiotics conferring the greatest
risk were the broad spectrum variety. The researchers also found that
early antibiotic use was associated with a wide range of allergies.
Dr Johnson, who presented these findings this week at the European
Respiratory Congress in Vienna, concludes that antibiotic use at the
beginning of life is mucking up infants' immune systems, malfunctions
of which manifest themselves in the form of asthma and allergies. No
one is sure exactly how infants' immune systems learn to distinguish
good bugs from bad, but killing off too many gut bacteria-even,
apparently, ones that cause illness-does appear to disrupt the
process.
The idea that childhood infections help to reduce the probability of
chronic diseases in later life by somehow "tuning" children's immune
systems is known as the "hygiene hypothesis". It suggests that the
growing incidence of chronic problems in the rich world is a
consequence of better hygiene and access to medical treatment, both
of which reduce the incidence of childhood infections, and affect the
immune system early in life. As evidence for this hypothesis grows, it
is becoming more popular-and not just among scientists. Mothers
with sticky kitchen floors and furniture lined with cathair love it too.
----------------------
Infants Given Antibiotics at Risk for Allergy
Reuters Health, Tuesday, 30 September 2003
By Megan Rauscher
New York - Treating infants with antibiotics seems to increase their
risk of developing childhood diseases like eczema and allergic
asthma, a new study suggests.
There are conflicting reports on whether exposure to antibiotics in
infancy raises the risk of allergies and asthma. The latest findings
were presented Tuesday at the European Respiratory Society's
annual conference in Vienna by Dr. Christine Cole Johnson, a senior
research epidemiologist for Henry Ford Health System in Detroit,
Michigan.
Her team reviewed the medical records of 445 children participating
in an HMO-based study in the Detroit area. Almost half of the children
had been treated with an antibiotic in the first 6 months of life. The
children were followed for the development of allergic conditions until
age 6 and 7 when they were evaluated by an allergist.
Children who had been treated with an antibiotic were 1.5 times more
likely to have allergies and 2.5 times more likely to have allergic
asthma by the age of 7, compared with children not given antibiotics
in infancy.
The link between early antibiotic exposure and the development of
allergy and asthma was stronger in children whose mothers had
similar conditions, and among children who did not have pets in the
home.
This finding on household pets supports the "hygiene hypothesis,"
which holds that early exposure in life to bacterial infection and
bacterial products prevents the development of allergic disease. Early
antibiotic use may influence the gastrointestinal tract and alter the
development of the maturing immune system.
"You are exposed to a lot of bacteria when you have pets around. For
kids that are in a so-called sterile environment, antibiotics may be
more of a risk factor," Johnson explained.
"Interestingly," she said, the link between early antibiotic use and
atopy was also stronger among children who had been breast fed for
four months or longer. "The jury is out on whether breast-feeding is
good or bad regarding allergies," Johnson said.
The current study supports the ongoing trend to limit the use of
antibiotics. "Infants that do require antibiotics might be monitored for
allergies and asthma," she added.
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