Increased risk of childhood asthma from antibiotic use in early life

Chest. 2007 Jun;131(6):1753-9. doi: 10.1378/chest.06-3008. Epub 2007 Apr 5.


Background: To address the major methodological issues of reverse causation and selection bias in epidemiologic studies of antibiotic use in early life and the development of asthma, we undertook a cohort study of this association in a complete population of children.

Methods: Using the health-care and prescription databases of Manitoba, Canada, this longitudinal study assessed the association between antibiotic prescription use during the first year of life and asthma at age 7 years in a 1995 birth cohort of 13,116 children.

Results: Independent of well-known asthma risk factors, asthma was significantly more likely to develop in children who had received antibiotics in the first year of life at age 7 years. The association with asthma was observed for antibiotic use in non-respiratory tract infections (adjusted odds ratio [OR], 1.86; 95% confidence interval [CI], 1.02 to 3.37). The risk of asthma was highest in children receiving more than four courses of antibiotics (adjusted OR, 1.46; 95% CI, 1.14 to 1.88), especially among rural children, and in the absence of maternal asthma or a dog in the birth year. Broad-spectrum (BS) cephalosporin use was more common in these subpopulations of children.

Conclusions: Antibiotic use in early life was associated with the development of childhood asthma, a risk that may be reduced by avoiding the use of BS cephalosporins.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Asthma / epidemiology*
  • Cephalosporins / therapeutic use*
  • Child
  • Cohort Studies
  • Drug Hypersensitivity / epidemiology
  • Female
  • Humans
  • Infant
  • Infant Welfare
  • Longitudinal Studies
  • Male
  • Manitoba / epidemiology
  • Odds Ratio
  • Respiratory Tract Infections / drug therapy
  • Risk Factors


  • Anti-Bacterial Agents
  • Cephalosporins