Relation of early antibiotic use to childhood asthma: confounding by indication?
Relation of early antibiotic use to childhood asthma: confounding by indication?
复制标题
早期抗生素使用与儿童哮喘的关系：因适应症而混淆？
DOI：
10.1111/j.1365-2222.2010.03539.x
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发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Wright,AL
中科院分区：
文献类型：
--
作者：
Su,Y;Rothers,J;Stern,DA;Halonen,M;Wright,AL
背景早期使用抗生素与随后哮喘之间关系的研究结果一直不一致，这可能归因于方法学问题。我们的目的是在一个非选择的出生队列（n=424）中评估适应症对早期抗生素使用与5岁以下儿童哮喘关系的混杂影响。方法通过频繁的护士访谈评估出生后前9个月口服抗生素的使用情况。在1、2、3和5年时通过问卷调查评估医生诊断的活动性哮喘和湿疹，如果在任何年龄时呈阳性，则认为是哮喘或湿疹。在第1、2、3和5年时评估血浆中的过敏原特异性IgE。通过考虑哮喘与抗生素使用的关系，同时控制疾病的数量，以医生在早期life.ResultsThere没有统计学意义的早期抗生素使用与医生诊断的湿疹或过敏原特异性IgE的关系进行了研究。有哮喘史者使用抗生素的剂量反应关系明显（OR = 1.5，P =0.047）。有哮喘史者随就诊次数的增加而显著增加（P<0.001）。调整后的疾病访问次数，抗生素的使用表明没有关系与asthma.ConclusionsThe哮喘的关系，抗生素在这个队列似乎是一个人工制品的强烈关系的医生访问的疾病与抗生素的使用和哮喘的风险。Su，J. Rothers，D. A. Stern，M. Halonen和A. L. Wright，临床与实验过敏，2010（40）1222-1229.
BackgroundFindings from studies of the relation between early antibiotic use and subsequent asthma have been inconsistent, which may be attributable to methodologic issues.ObjectiveOur objective was to assess the impact of confounding by indication on the relation of early antibiotic use to childhood asthma through age 5 in a non‐selected birth cohort (n=424).MethodsOral antibiotic use was assessed by frequent nurse interviews in the first 9 months of life. Physician‐diagnosed active asthma and eczema were assessed by questionnaire at 1, 2, 3, and 5 years, and were considered as ever asthma or ever eczema if positive at any age. Allergen‐specific IgE was assessed in plasma at 1, 2, 3, and 5 years. Confounding by indication was investigated by considering the relation of asthma to antibiotic use while controlling for the number of illness visits to a physician in early life.ResultsThere was no statistically significant relation of early antibiotic use with physician‐diagnosed eczema or allergen‐specific IgE. A dose–response relation was evident for antibiotic use with ever asthma (odds ratio [OR]=1.5,P=0.047). Ever asthma also increased significantly with the number of illness visits to a physician (P<0.001). After adjustment for number of illness visits, antibiotic use showed no relation with asthma.ConclusionsThe relation of asthma to antibiotics in this cohort appears to be an artefact of the strong relation of number of physician visits for illness with both antibiotic use and risk for asthma.Cite this as: Y. Su, J. Rothers, D. A. Stern, M. Halonen and A. L. Wright,Clinical & Experimental Allergy, 2010 (40) 1222–1229.