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Asthma, antibiotics linked in food-allergic kids.

WASHINGTON -- Pneumonia, sinus infections, and antibiotic use in a child's first year of life were independently associated with asthma in a study of more than 1,000 children with food allergies.

Children with a history of antibiotic use in the first year of life had an almost twofold increased risk of asthma (odds ratio, 1.8), after adjustment for age, sex, household income, maternal education, breastfeeding, mode of delivery, family atopy, and intrafamilial correlations. Even after adjustment for antibiotic use, pneumonia and sinus infection in early life were significantly associated with an increased risk of asthma (OR, 2.2 and 2.0), Angela Schroeder and her coinvestigators reported in a poster presented at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.

The study involved 1,105 children enrolled in an ongoing family-based food-allergy study in Chicago. The researchers used a questionnaire-based interview to obtain information about food allergies and medical histories of each family member.

A clinical evaluation--including measures of height, weight, and blood pressure and a skin prick test--was performed on each participating family member. Venous blood samples also were taken. In addition, ICD-9 codes were collected for children who received care in the allergy and immunology clinic at Children's Memorial Hospital, Chicago; those were compared with parental report of physician diagnosis in the child's first year.

The investigators determined antibiotic use in early life by questionnaire-based interviews and defined it by parental report of physician-prescribed antibiotics in their child's first year of life. They also assessed early infections by questionnaire-based interviews for otitis media, pneumonia, skin infection, urinary tract infection, parasite infection, bone infection, meningitis, bacteremia/sepsis, and sinus infection. The researchers defined asthma as parental report of physician diagnosis and being symptomatic in the year prior to the survey, as determined by interview. They determined the earliest age of reported asthma symptoms.

In all, 30% of children had asthma. Half of children with asthma had otitis media in the first year of life, compared with 40% of children without asthma. Likewise, 7% of children with asthma had pneumonia and 9% had sinus infection, compared with 2% and 4% of children without asthma.

More than two-thirds of children with asthma (68%) had used antibiotics in the first year of life, compared with 54% of children without asthma.

All of the differences were statistically significant.

Ms. Schroeder, who is a research associate at Children's Memorial Hospital, reported that she has no relevant Financial relationships.

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Author:Wachter, Kerri
Publication:Pediatric News
Date:May 1, 2009
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