Early childhood infections and the use of antibiotics and antipyretic-analgesics in Finland, Estonia and Russian Karelia

Acta Paediatr. 2019 Nov;108(11):2075-2082. doi: 10.1111/apa.14874. Epub 2019 Jun 23.

Abstract

Aim: Infections in early childhood are common reasons to seek medical attention. This study compares the prevalence of infections, and the use of antibiotics and antipyretic-analgesics, in children from Finland, Estonia and Russian Karelia.

Methods: Children with a genetically increased risk for type 1 diabetes (N = 797) were observed from birth up to 3 years of age. Illnesses and medications were reported by parents continuously. All reported infections, antibiotics and antipyretic-analgesics were compared between Finland and Estonia, and to a lesser extent with Russian Karelia, due to poor study compliance.

Results: Compared with Estonians, Finns reported more infections during the first and second years of life. During the follow-up, Finnish children had 10 infections while Estonians only had 8 (p < 0.001). Finns also used more antibiotics and antipyretic-analgesics in each year during the follow-up. Russian Karelians reported the lowest frequency of infections and the most infrequent use of antibiotics and antipyretic-analgesics in the first two years of life.

Conclusion: Infections and the use of antibiotics and antipyretic-analgesics in early childhood were most frequent in Finland, where socio-economic conditions are the most developed and microbial encounters are sparse. This may reflect on the hygiene hypothesis, a less effective immune system that allows normally harmless microbes to attack and cause clinical infections.

Keywords: Antibiotics; Antipyretic-analgesics; Childhood infections; The hygiene hypothesis.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Analgesics / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Antipyretics / therapeutic use*
  • Bacterial Infections / drug therapy*
  • Bacterial Infections / epidemiology*
  • Child, Preschool
  • Cohort Studies
  • Drug Utilization / statistics & numerical data*
  • Estonia / epidemiology
  • Female
  • Finland / epidemiology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Prevalence
  • Russia / epidemiology

Substances

  • Analgesics
  • Anti-Bacterial Agents
  • Antipyretics