Early life antibiotic use and the risk of asthma and asthma exacerbations in children

Fariba Ahmadizar, Susanne J H Vijverberg, Hubertus G. M. Arets, Anthonius de Boer, Graham S Devereux, Steve Turner, Ali Arabkhazaeli, Patricia Soares, Somnath Mukhopadhyay, Johan Garssen, Colin N.A. Palmer, Johan C. de Jongste, Vincent WV Jaddoe, Liesbeth Duijts, Evelien R. van Meel, Aletta D. Kraneveld, Anke H Maitland-van der Zee (Corresponding Author)

Research output: Contribution to journalArticlepeer-review

72 Citations (Scopus)
12 Downloads (Pure)



The use of antibiotic therapy early in life might influence the risk of developing asthma. Studies assessing the influence of early life antibiotic use on the risk of asthma exacerbations are limited, and the results are inconsistent. Therefore, the aim of this study was to assess the association between use of antibiotic during the first three years of life and the risk of developing childhood asthma and the occurrence of asthma exacerbations.

Data from four large childhood cohorts were used; two population-based cohorts to study the risk of developing asthma: Generation R (n=7,393, the Netherlands) and SEATON (n=891, Scotland, UK), and two asthma cohorts to assess the risk of asthma exacerbations: PACMAN (n=668, the Netherlands) and BREATHE (n=806, Scotland, UK). Odds ratios (ORs) were derived from logistic regression analysis within each database followed by pooling the results using a fixed- or random-effect model.

Antibiotic use in early life was associated with an increased risk of asthma in a meta-analysis of the Generation R and SEATON data (OR: 2.18, 95% CI: 1.04-4.60; I2: 76.3%). There was no association between antibiotic use in early life and risk of asthma exacerbations later in life in a meta-analysis of the PACMAN and BREATHE data (OR: 0.93, 95% CI: 0.65-1.32; I2: 0.0%).

Children treated with antibiotic in the first three years of life are more likely to develop asthma, but there is no evidence that the exposure to antibiotic is associated with increased risk of asthma exacerbations.

This article is protected by copyright. All rights reserved.
Original languageEnglish
Pages (from-to)430-437
Number of pages8
JournalPediatric Allergy & Immunology
Issue number5
Early online date8 Jun 2017
Publication statusPublished - Aug 2017


  • antibiotic
  • asthma
  • asthma exacerbations
  • early life
  • pediatrics


Dive into the research topics of 'Early life antibiotic use and the risk of asthma and asthma exacerbations in children'. Together they form a unique fingerprint.

Cite this