生命早期抗生素暴露,或带来健康损害风险
创作:尹小甜 审核:Epi汪 2020年11月20日
  • 纳入14572名儿童队列数据,其中70%的儿童在2岁前均服用过抗生素,随访未来患病风险;
  • 暴露组儿童增加哮喘风险,且随着抗生素暴露剂量的增加,风险增加呈现剂量反应关系;
  • 同时,抗生素暴露组儿童未来过敏性鼻炎、特应性皮炎、超重、肥胖、注意缺陷多动障碍等疾病的风险均有不同程度增加;
  • 对于女孩来说,暴露组儿童乳糜泻的风险增加;
  • 不同抗生素暴露,包括青霉素、头孢菌素、磺酰胺类和大环内酯类,对上述疾病的关联各不相同。
主编推荐语
Epi汪
本研究通过儿童队列数据分析发现,在生命早期(前2年内)使用过抗生素处方的儿童,在未来发生哮喘等疾病的风险增高。抗生素暴露可能通过改变肠道菌群结构,从而对全身各系统造成健康损害。但是注意到,生命早期暴露抗生素的儿童可能本身具有遗传性疾病,或先天免疫力低下,这是否成为本研究的主要混杂因素?
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Association of Infant Antibiotic Exposure With Childhood Health Outcomes

婴儿抗生素使用与儿童健康的关联

10.1016/j.mayocp.2020.07.019

2020-11-15, Article

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Objective: To investigate the extent to which antibiotic exposure in the first 2 years of life is associated with the risk of immunological, metabolic, and neurobehavioral health conditions with childhood onset.
Patients and Methods: In this population-based cohort study, we identified all children born in Olmsted County, Minnesota, between January 1, 2003, and December 31, 2011, through the Rochester Epidemiology Project medical records-linkage system. Demographic characteristics, antibiotic prescriptions, and diagnostic codes through June 30, 2017, were retrieved using the Rochester Epidemiology Project infrastructure. Time-to-event analysis was performed to assess the impact of antibiotic exposure on the risk of several adverse health conditions.
Results: This study included 14,572 children (7026 girls and 7546 boys), of whom 70% (10,220) received at least 1 antibiotic prescription during the first 2 years of life. Early antibiotic exposure was associated with an increased risk of childhood-onset asthma, allergic rhinitis, atopic dermatitis, celiac disease, overweight, obesity, and attention deficit hyperactivity disorder (hazard ratios ranging from 1.20 to 2.89; P<.05 for all). The associations were influenced by the number, type, and timing of antibiotic exposure. Moreover, children exposed to antibiotics had a higher probability of having combinations of conditions, particularly when given multiple prescriptions.
Conclusion: The present study finds significant associations between early life antibiotic exposure and several distinct health conditions with childhood onset. Additional research is warranted to establish practical guidelines to optimize the benefit and minimize the risk of antibiotics in children.

First Authors:
Zaira Aversa

Correspondence Authors:
Walter A Rocca

All Authors:
Zaira Aversa,Elizabeth J Atkinson,Marissa J Schafer,Regan N Theiler,Walter A Rocca,Martin J Blaser,Nathan K LeBrasseur

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