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Early Antibiotics May Raise Asthma Risk

Studies Suggest Risk Is Double for Treated Babies
WebMD Health News
Reviewed by Louise Chang, MD

March 13, 2006 -- Babies treated with even one course of antibiotics during their first year of life may have twice the risk of developing asthma later in childhood as unexposed babies, an analysis of past research shows.

The findings bolster the theory that an increase in the use of antibiotics early in life may be a factor in the epidemic rise in childhood asthma. They also suggest that greater exposure to antibiotics is associated with greater asthma risk.

Approximately one in eight children in the U.S. has asthma, and asthma rates among children under age 5 have increased especially between 1980 and the mid-1990s, according to figures from the CDC.

While results from the pooled studies point to a link between early antibiotic exposure and asthma, they fall short of proving the association, says Carlo A. Marra, PhD, PharmD, of the University of British Columbia.

"Antibiotic exposure during the first year of life does appear to be a risk factor for the development of childhood asthma, but because of limitations in the studies we reviewed we have to conclude that bigger and better studies are still needed," he tells WebMD.

Different Studies, Different Findings

The association between early antibiotic use and childhood asthma was significantly stronger in studies that relied on parent recall than in those that followed children over time.

Marra says the recall, or retrospective, studies may have been compromised by bias. Specifically, the parents of the children with asthma may have been more likely to report early antibiotic exposures than parents of children without asthma.

An analysis of five studies that examined the effect of treating infants with multiple courses of antibiotics showed that greater exposure to the drugs was associated with greater asthma risk. But this association was again seen in the retrospective studies.

The study is published in the March issue of the journal Chest.

Hygiene Hypothesis

While not conclusive, Marra says the findings offer some of the strongest supporting evidence yet in favor of the so-called 'hygiene hypothesis,' which suggests that increasingly sterile environments may be making children more susceptible to allergies and asthma.

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