哮喘联盟

   摘要
   目的：本研究旨在测评墨西哥裔美国儿童婴儿时期的抗生素用药史与医生确诊为终生哮喘和现患喘鸣的关联。
   方法：对2,023例年龄为4～18岁儿童的父母进行基于人群的横断面调查，完成问卷调查，访谈呼吸系统状况、 抗生素的用药及其协变量。
   结果：基于调整后的分析，抽样婴儿时期没有耳部感染病史的儿童进行实验。婴儿期有过≥3次或1-2次抗生素用药史的儿童，较之婴儿期没有抗生素用药史的儿童，更容易被医生确诊为哮喘[校正优势比（aOR）=5.14，95%可信区间（CI）：2.88-9.17和校正优势比（aOR）= 2.15，95%可信区间（CI）：1.26-3.69，P <0.0001]。现患喘鸣的儿童的优势比 （aOR）分别为 3.67（95%可信区间（CI）：1.95-6.89）和1.63（95%可信区间（CI）：0.91-2.95）。有过耳部感染的儿童，在婴儿时期的抗生素用药史，与其哮喘发病或现患喘鸣无关。在补充分析中发现，无哮喘及过敏家族史的儿童，婴儿时期的抗生素用药史与儿童哮喘发病相关（优势比（aOR） = 2.73，95%可信区间（CI）：1.70-4.39) ；而对有哮喘及过敏家族史的儿童则显示无关。这些在墨西哥农村地区出生的美国儿童受试者，婴儿时期的抗生素用药使他们的哮喘发病风险增加7倍（优势比（aOR=7.21，95%可信区间（CI）：1.46-35.65），而墨西哥城市地区出生的墨西哥儿童则未显示关联。
   结论：婴儿时期抗生素的用药史可能增加哮喘和喘鸣的发病风险。这一关联仅适用于儿童。
 

（苏欣 审校）
J Asthma. 2015 Jan 13:1-20. [Epub ahead of print]


 

Antibiotic use in infancy and the risk of asthma in Mexican American children.
 

Eldeirawi KM1, Kunzweiler C, Atek A, Persky VW.
 

Abstract
OBJECTIVE: This study examined the associations of antibiotic use in infancy with lifetime doctor-diagnosed asthma and current wheeze among Mexican American children.
METHODS: In a population-based, cross-sectional investigation, parents of 2,023 children 4-18 years of age completed a questionnaire/interview addressing respiratory conditions, antibiotic use, and covariates.
RESULTS: In adjusted analyses, among children without history of ear infections in infancy, children who used antibiotics ≥ 3 times and 1-2 times were more likely to report doctor-diagnosed asthma compared with their peers who did not use antibiotics in infancy [adjusted odds ratio (aOR) = 5.14, 95% confidence interval (CI): 2.88-9.17, and aOR = 2.15, 95% CI: 1.26-3.69, respectively, p trend < 0.0001].The respective aORs for current wheeze were 3.67 (95% CI: 1.95-6.89) and 1.63 (95% CI: 0.91-2.95). Antibiotic use in infancy was not associated with asthma or current wheeze in children who had ear infections in infancy. In additional analyses, antibiotic use in infancy was associated with asthma in children without parental history of asthma or allergies (aOR = 2.73, 95% CI: 1.70-4.39) but not in those with parental history of asthma or allergies. Among Mexico-born participants born in rural areas, antibiotic use in infancy was associated with a 7-fold increase in risk of asthma (aOR = 7.21, 95% CI: 1.46-35.65), while the association was non-significant in Mexico-born children born in urban areas in Mexico.
CONCLUSIONS: Antibiotic use in infancy may increase the risk of asthma and wheezing, but these associations were limited to subgroups of children.
 

J Asthma. 2015 Jan 13:1-20. [Epub ahead of print]