Early-Life Antibiotic Exposure and Childhood Asthma Trajectories: A National Population-Based Birth Cohort

• Main Authors: Yankun Lu (Author), Yichao Wang (Author), Jing Wang (Author), Adrian J. Lowe (Author), Luke E. Grzeskowiak (Author), Yanhong J. Hu (Author)
• Format: Book
• Published: MDPI AG, 2023-02-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.3390/antibiotics12020314; 2079-6382
• Keywords: early-life; antibiotic; childhood; asthma; trajectory; birth cohort; Therapeutics. Pharmacology; RM1-950
• Source: Antibiotics, Vol 12, Iss 2, p 314 (2023)

Introduction: Early-life antibiotic exposure is common and impacts the development of the child's microbiome and immune system. Information on the impacts of early-life antibiotics exposure on childhood asthma is lacking. Methods: This study examined associations between early-life (0-24 months) antibiotics exposure with childhood (6-15 years) asthma trajectories through the Australian Longitudinal Study of Australian Children (LSAC) and their linked data from the Pharmaceutical Benefits Scheme. Asthma phenotypes were derived by group-based trajectory modeling. Results: Of 5107 LSAC participants, 4318 were included in the final analyses (84.6% retention). Four asthma phenotypes were identified: Always-low-risk (79.0%), early-resolving asthma (7.1%), early-persistent asthma (7.9%), and late-onset asthma (6.0%). Any early-life antibiotic exposure increased risk 2.3-fold (95% CI: 1.47-3.67; <i>p</i> < 0.001) for early-persistent asthma among all children. In subgroup analyses, early-persistent asthma risk increased by 2.7-fold with any second-generation cephalosporin exposure, and by 2-fold with any β-lactam other than cephalosporin or macrolide exposure. Conclusion: We concluded that early-life antibiotic exposure is associated with an increased risk of early-persistent childhood asthma. This reinforces scrutiny of early-life antibiotic use, particularly for common viral infections where no antibiotics are required.