Triclosan and triclocarban exposure, infectious disease symptoms and antibiotic prescription in infants-A community-based randomized intervention
Triclosan and triclocarban exposure, infectious disease symptoms and antibiotic prescription in infants-A community-based randomized intervention
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DOI：
10.1371/journal.pone.0199298
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发表时间：
2018-06-28
期刊：
影响因子：
3.7
通讯作者：
Parsonnet, Julie
中科院分区：
文献类型：
--
作者：
Ley, Catherine;Sundaram, Vandana;Parsonnet, Julie
背景三氯生和三氯卡班（TC）是广谱抗菌剂，直到最近，才在各种家庭和个人洗涤产品中发现。受消费者欢迎，TC尚未被证明可以防止传染病。ObjectivesTo确定是否使用含TC的洗涤产品减少感染的发生率在儿童不到一岁的age.MethodsStarting在2011年，我们嵌套的随机干预洗涤产品与和不TC内多种族的出生队列。每周通过自动调查收集感染性疾病症状和抗生素使用的孕产妇报告;每四个月进行一次家庭访问。通过病历审查确定抗生素处方。在参与者亚组中测量尿液三氯生水平。采用混合效应logistic回归和Fisher精确检验，分别评估了干预组报告的感染性疾病（主要结局）和抗生素使用（次要结局）的差异。ResultsInfectious disease happened in 6% of weeks，with upper respiratory disease the dominant syndrome.在60名（45%）TC暴露婴儿和73名（55%）非TC暴露婴儿中，两组之间的传染病报告频率没有差异（似然比检验：p = 0.88）。与非TC组相比，TC组中使用抗生素处方的医疗访视较少（分别为7.8%和16.6%; p = 0.02）。结论：尽管随机使用含TC的洗涤产品与母亲感染性疾病报告的减少无关，但TC与抗生素处方的减少有关，表明对细菌感染有益。最近从消费者洗涤产品中去除TC使得进一步阐明益处和风险不切实际。
BackgroundTriclosan and triclocarban (TCs) are broad-spectrum antimicrobials that, until recently, were found in a wide variety of household and personal wash products. Popular with consumers, TCs have not been shown to protect against infectious diseases.ObjectivesTo determine whether use of TC-containing wash products reduces incidence of infection in children less than one year of age.MethodsStarting in 2011, we nested a randomized intervention of wash products with and without TCs within a multiethnic birth cohort. Maternal reports of infectious disease symptoms and antibiotic use were collected weekly by automated survey; household visits occurred every four months. Antibiotic prescriptions were identified by medical chart review. Urinary triclosan levels were measured in a participant subset. Differences by intervention group in reported infectious disease (primary outcome) and antibiotic use (secondary outcome) were assessed using mixed effects logistic regression and Fisher's Exact tests, respectively.ResultsInfectious illness occurred in 6% of weeks, with upper respiratory illness the predominant syndrome. Among 60 (45%) TC-exposed and 73 (55%) non-TC-exposed babies, infectious disease reports did not differ in frequency between groups (likelihood ratio test: p = 0.88). Medical visits with antibiotic prescriptions were less common in the TC group than in the non-TC group (7.8% vs. 16.6%, respectively; p = 0.02). ConclusionsAlthough randomization to TC-containing wash products was not associated with decreased infectious disease reports by mothers, TCs were associated with decreased antibiotic prescriptions, suggesting a benefit against bacterial infection. The recent removal of TCs from consumer wash products makes further elucidation of benefits and risks impracticable.