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Allergies, Asthma, and Antibiotics?

A new study titled “Association Between Use of Acid-Suppressive Medications and Antibiotics During Infancy and Allergic Diseases in Early Childhood” was released earlier this month in the JAMA Pediatrics. It is a noteworthy finding in the debate among medical professionals regarding the proper prescribing practices and metrics they should be using to guide their treatment plans for bacterial infections.

This is not the first time a link between antibiotics and allergic diseases has been investigated. There is a study from 2017 that correlates antibiotic use in early childhood to the development of asthma, although there is no link between antibiotics and asthma exacerbation episodes. An even earlier study from June, 2007 presents concerns for a link between asthma and broad spectrum cephalosporin usage. The study states that, “asthma was significantly more likely to develop in children who had received antibiotics in the first year of life at age 7 years [and] the association with asthma was observed for antibiotic use in non-respiratory tract infections,” particularly in association with broad spectrum cephalosporins.

Of course with any study, there are limitations to the findings we outlined above. Perhaps the 2007 study, which focused on children in Manitoba, Canada has some other differentiating factor that was not discussed in the study. Maybe their water is different or the cooler climate has an effect that was not accounted for. The new study I cited at the start of this post lists its possible limitations at the end of the study (as all good studies should). Things like misdiagnoses, mismanagement of treatments or a biased sample population can play a role in affecting the results the scientists found. Dr.Arnaout at Cook Children Medical Center in Fort Worth brings an important discussion of understanding the limitations of a study to the forefront of these new conclusions. We are still learning about the body’s development and how it interact with treatments.

As a matter of fact, a 2014 study by the University of Manchester notes that these findings may be the result of a third variable. An article in on the University of Manchester website summarizes the study by stating, “impaired viral immunity and genetic variants on a region of chromosome 17 that increase the risk of both antibiotic use in early life and later asthma.” So, while there may be increasing evidence of a link between antibiotics and allergic diseases, we still do not have definitive proof of the correlation, only the absence of something disproving the correlation (which is the basis of science as it is!)

As we continue to learn more about antibiotics and how they affect our bodies, more studies like this are likely to be released in the future. The practice of medicine is just that, a practice. New discoveries will be made and the course of practice will evolve as we continue to improve and refine our management of health and disease.

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