Exploring the potential mediating role of systemic antibiotics in the association between early-life lower respiratory tract infections and asthma at age 5 in the CHILD study

Medeleanu MV 1 , Reyna ME 1 , Dai DLY 2 , Winsor GL 3 , Brinkman FSL 3 , Verma R 4 Show all authors , Nugent E 1 , Riaz N 1 , Simons E 5 , Mandhane PJ 6 , Azad MB 7 , Turvey SE 2 , Moraes TJ 1 , Subbarao P 1

Affiliations 

  • 1 Translational Medicine Program, The Hospital for Sick Children, Toronto, ON, Canada
  • 2 Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, BC, Canada
  • 3 Department of Molecular Biology and Biochemistry, Simon Fraser University, Burnaby, BC, Canada
  • 4 Division of Respiratory Medicine, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada
  • 5 Department of Pediatrics and Child Health, Section of Allergy and Immunology, University of Manitoba, Winnipeg, MB, Canada
  • 6 Department of Pediatrics, University of Alberta, Edmonton, AB, Canada
  • 7 Manitoba Interdisciplinary Lactation Centre (MILC), Children's Hospital Research Institute of Manitoba, Winnipeg, MB, Canada
Front Allergy, 2024;5:1463867.
PMID: 39906720 DOI: 10.3389/falgy.2024.1463867

Abstract

OBJECTIVE: Lower respiratory tract infections (LRTIs) in early life are one of the strongest risk factors for childhood asthma and are often treated with systemic antibiotics (IV or oral). We aimed to explore the association between early-life LRTIs and systemic antibiotics on asthma development and the potential mediating role of antibiotics in this relationship.

METHODS: Data were collected as part of the longitudinal, general Canadian population CHILD Study. LRTIs during the first 18 months of life were identified through parental symptom report at regular study visits. Systemic antibiotic use was defined as at least one dose of oral/intravenous antibiotics between birth and the 18-month visit and were further categorized by indication as either given for a respiratory indication (upper or lower respiratory symptoms) or non-respiratory indication. Asthma was diagnosed by in-study pediatricians at the 5-year study visit. Adjusted logistic regression models and mediation analyses via systemic antibiotics use were performed.

RESULTS: Among 2,073 participants included in our analysis, 72 (4.9%) had asthma age 5, and 609 (29.3%) used systemic antibiotics before the 18-month visit. Among children who had taken antibiotics, 61.6% also had an LRTI in that period compared to 49.7% among children without exposure to systemic antibiotics (p 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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