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Use of Antibacterials in Infancy

Clinical Implications for Childhood Asthma and Allergies

Abstract

Evidence from experimental studies in rodents and results from epidemiologic studies with a retrospective design suggest a possible causal association between antibacterial use in early childhood and asthma. Such an association is thought to be mediated by antibacterial-induced alterations in the intestinal flora, leading to a skewing of the immune system of young children toward an atopic phenotype. However, results from recently conducted prospective studies suggest that the previously observed association between antibacterial use in early childhood and asthma is not one of ‘cause and effect’ but rather that frequent antibacterial use in early childhood may be a marker of an increased risk of being diagnosed with asthma later in childhood. Although antibacterials should not be used excessively in young children, their use in early childhood is not likely to explain the increased prevalence of asthma and allergies in children in industrialized countries.

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Acknowledgment

Dr Celedón is supported by a KO1 Award (HL04370-01A1) from the National Heart, Lung, and Blood Institute. We thank Ms Nancy K. Voynow and Ms Catherine Liang for their assistance in preparing the manuscript. The authors have no conflicts of interest directly relevant to the content of this review.

Author information

Correspondence to Dr Juan C. Celedón.

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Celedón, J.C., Weiss, S.T. Use of Antibacterials in Infancy. Treat Respir Med 3, 291–294 (2004). https://doi.org/10.2165/00151829-200403050-00003

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Keywords

  • Asthma
  • Early Childhood
  • Atopic Dermatitis
  • Early Life
  • Allergic Rhinitis