1岁内婴儿应慎用抗生素
2008/08/13
新华社斯德哥尔摩5月9日报道，瑞典研究人员最近发现，新生儿应用抗生素治疗，可能增加以后喘息的发病风险。该研究结果在近期美国杂志《Pediatrics》上发表。
瑞典哥德堡大学的研究人员在对5000名儿童进行调查后发现，如果在出生后的第一年接受抗生素药物治疗，那么他们在成长过程中患哮喘的危险性要比其他儿童高出300％。
研究人员分析说，这主要是因为抗生素在治疗疾病的同时，也破坏婴儿肠道中从母体获得的有益菌群，从而损害婴儿自身的免疫系统的发育。
（陈七一 赵京 首都儿科研究所哮喘教育与防治中心 100020 摘译）
(Pediatrics 121（4）:697-702)
Neonatal Antibiotic Treatment Is a Risk Factor for Early Wheezing
Bernt Alm, MD, PhDa, Laslo Erdes, MDb, Per Möllborg, MDc, Rolf Pettersson, MDd, S. Gunnar Norvenius, MD, PhDa, Nils Åberg, MD, PhDa and Göran Wennergren, MD, PhDa
a Department of Pediatrics, Göteborg University, Göteborg, Sweden
b Pediatric Outpatient Clinic, Skene, Sweden
c Central Infant Welfare Bureau, Uddevalla Hospital, Uddevalla, Sweden
d Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
b Pediatric Outpatient Clinic, Skene, Sweden
c Central Infant Welfare Bureau, Uddevalla Hospital, Uddevalla, Sweden
d Department of Pediatrics, Skaraborg Hospital, Skövde, Sweden
abstract摘要
OBJECTIVE:The use of antibiotics in infancy and subsequent changes in the intestinal bacterial flora have been discussed as risk factors for the development of asthma. However, it has been difficult to exclude the possibility that antibiotics have been given in early episodes of wheezing. As a result, there has been a risk of reverse causation. To minimize the risk of reverse causation, we have focused on the effect of antibiotics that are already administered on the neonatal ward.
METHODS: In a cohort study of infants born in western Sweden in 2003, we studied the development of wheezing. The families of the infants were randomly selected and sent a questionnaire at child ages 6 and 12 months. The response rate was 68.5% to the 6-month questionnaire and 68.9% to the 12-month questionnaire.
RESULTS: At 12 months, 20.2% of infants had had 1 or more episodes of wheezing, and 5.3% had had 3 or more episodes. Inhaled corticosteroids had been taken by 4.1% of the infants. Independent risk factors for wheezing disorder treated with inhaled corticosteroids were neonatal antibiotic treatment, male gender, gestational age of <37 weeks, having a mother with asthma, having a sibling with asthma or eczema, and breastfeeding for <5 months.
CONCLUSIONS: Treatment with antibiotics in the neonatal period was an independent risk factor for wheezing that was treated with inhaled corticosteroids at 12 months of age. These results indirectly support the hypothesis that an alteration in the intestinal flora can increase the risk of subsequent wheezing.
Key Words: antibiotics cohort studies infant wheezing
Abbreviations: BPD—bronchopulmonary dysplasia OR—odds ratio CI—confidence interval
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无症状气道高反应性和变应性是哮喘的危险因素吗？一项纵向研究
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哮喘患者接受抗生素、镇咳、祛痰药物治疗的调查报告
