• Santos Karoliny Dos KD Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, SC, Brazil; Allergy and Lung Health Unit, Melbourne School, Caroline J Lodge, Michael J Abramson, Bircan Erbas, Catherine M Bennett, Jennie Hui, Shyamali C Dharmage, and Adrian J Lowe.
• Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Palhoça, SC, Brazil; Allergy and Lung Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, Australia.
• Chest. 2020 Feb 1; 157 (2): 334-341.

BackgroundAlthough there is ongoing debate regarding the impact of early postnatal exposure to antibiotics on the development of asthma, the possibility that antibiotic exposure may impair lung function has not previously been examined. Furthermore, it is unclear if specific types of antibiotics may have a greater effect, or if children with genetic mutations in the oxidative stress response glutathione S-transferase (GST) superfamily may be at greater risk.MethodsParent-reported data of childhood antibiotic use from birth to 2 years, including type and indication, were collected from a birth cohort of 620 infants with a family history of allergy. Spirometry was performed at age 12 and 18 years, and results are presented as z scores. Participants were genotyped for GST-P, GST-M, and GST-T polymorphisms. Linear regression models were used to investigate the associations while adjusting for confounding factors.ResultsNeither increasing days of exposure nor earlier exposure to antibiotics was associated with reduced FEV1 (at 18 years, per doubling of days of exposure = -0.03 z score units; 95% CI, -0.11 to 0.04) or FVC (< 0.01; 95% CI, -0.08 to 0.07). There was no evidence that GST-risk polymorphisms (M1, P1, and T1) increased susceptibility, and specific types of antibiotics also did not increase risk of lung function deficits.ConclusionsIncreasing exposure to oral antibiotics in early postnatal life was not associated with reduced lung function in children with a family history of allergic diseases. Although unwarranted use of antibiotics in children should be minimized, concerns regarding long-term lung health should not be a driving influence for this rationalization of use.Copyright © 2019. Published by Elsevier Inc.

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