Decline in childhood asthma linked to lower prescribing of unnecessary antibiotics

A research group in British Colombia found that a decline in childhood asthma observed in recent years was associated with lower prescribing of antibiotics during infancy and preservation of gut microbes.

The study analysis included population-level data from British Colombia between 2000 and 2014 and 2644 children enrolled in an ongoing birth cohort study called CHILD which began in 2008. For every 10% increase in the annual antibiotic prescribing rate, there was a 24% increase in asthma incidence. Antibiotic use in infancy below the age of 1 was associated with almost double the risk of an asthma diagnosis at aged 5.

To explore this association further, gut microbiota from 917 children in the CHILD study cohort were sampled. Early antibiotic exposure reduced bacterial diversity including two types with mechanistic links to asthma. Authors suggested that depletion of specific bacterial species could skew the developing immune system toward allergic phenotypes.

Why it matters: Antibiotic use in early childhood may cause microbial imbalances that compromise healthy immune development. This study suggests that antibiotics should be prescribed with caution during infancy to reduce asthma-related morbidity.

Source: The Lancet Respiratory Medicine