Childhood Antibiotics and Asthma

It seems these days that antibiotics are given out like candy. While there is certainly a time and place for them, many doctors won’t even bother to check if an infection is bacterial (which will typically respond well to antibiotics) versus viral (which won’t respond to antibiotics at all, or may even hinder the body’s ability to fight the infection). Much of this comes from patients insisting on antibiotics and shopping around until they find a doctor who will prescribe them and so some doctors have just taken to giving them out on the grounds that a patient will get them eventually, so why not from them? However, when it comes to one’s children, parents are naturally extremely cautious and even if they wouldn’t request antibiotics for themselves, are more likely to for their children. But in these developing children, are there any potential lasting affects to such antibiotic regimens?

In the June 2005 issue of “Journal of Allergy and Clinical Immunology” there was an article titled, “Antibiotic exposure in early infancy and risk for childhood atopy”. Atopy is essentially a broad term for allergies and other hypersensitivity reactions including asthma. In the study, 448 children born from 1987-1989 were examined at birth and had a follow-up at the age of 6-7. In the follow-up exam, they were allergy tested and compared histories of antibiotic use.  For “susceptible children”, antibiotic use was found to considerably increase the risk of atopy. One course raises the risk by 159%, two to 387%, and three courses to 415% with some groups of children having the risk increased by as much as 1920%. The primary suspected reason for this is the well-known fact that antibiotic use affects gut flora; the body’s natural and helpful bacteria in the stomach and intestines which assist in digestion.

What’s also interesting to note though, is what the definition of “susceptible children” was. Due to previous studies, it’s been found that decreasing the exposure to potential infections early in life leads to increased risk of allergies and asthma as well. Likewise, breastfeeding, due to providing the child with natural antibodies, also reduces the risks of allergies and asthma, so “susceptible children” was defined as ones with fewer than two pets in the household and with certain patterns of breastfeeding.

This study of course makes no distinction between appropriate or inappropriate antibiotic use, because the effects on the gut flora are the same regardless. So while one certainly should not forgo antibiotics for their children when it’s warranted and medically sound, it goes to show that avoiding antibiotic use when it isn’t appropriate is all the more important. After all, due to the increased risk with more courses of antibiotics, even a child who already needs antibiotics at one time will benefit by not having antibiotics when they aren’t needed.

--Joshua J. J. Jorde D.C.

Read the abstract here