Pre- and post-natal exposure to antibiotics and the development of eczema, recurrent wheezing and atopic sensitization in children up to the age of 4 years.

BACKGROUND: Little data are available on the relationship between indirect antibiotic exposure of the child in utero or during lactation and allergic diseases. On the other hand, several studies have been conducted on the association with direct post-natal antibiotic exposure, but the results are conflicting. OBJECTIVE: The aim of this study was to investigate pre- and post-natal antibiotic exposure and the subsequent development of eczema, recurrent wheeze and atopic sensitization in children up to the age of 4 years. METHODS: We conducted an aetiologic study in 773 children based on a prospective birth cohort project in which environmental and health information were collected using questionnaires. Antibiotic exposure was assessed as maternal antibiotic intake during pregnancy and during lactation and as medication intake of the child. The chronology of exposures and outcomes was taken into account during the data processing. At the age of 1 and 4 years, a blood sample was taken for the quantification of specific IgE. RESULTS: Prenatal antibiotic exposure was significantly positively associated with eczema, whereas no association was found with recurrent wheeze and atopic sensitization. We found a positive, although statistically not significant, association between antibiotic exposure through breastfeeding and recurrent wheeze. Neither eczema nor atopic sensitization was significantly associated with antibiotic exposure through breastfeeding. Finally, we observed a negative association between the use of antibiotics in the first year of life and eczema and atopic sensitization, and also between antibiotic use after the first year of life and recurrent wheeze, eczema and atopic sensitization. CONCLUSION: Indirect exposure to antibiotics (in utero and during lactation) increases the risk for allergic symptoms in children, while direct exposure to antibiotics appears to be protective. The biological mechanisms underlying these findings still need to be elucidated.

Changes in respiratory and allergic symptoms in schoolchildren from 1996 to 2002, results from the ISAAC surveys in Antwerp (Belgium).

Two cross sectional surveys (1995/1996 and 2001/2002) were carried out according to the ISAAC protocol among 6-7 and 13-14 year old schoolchildren in Antwerp, Belgium. A total of 8244 children participated in 1996 and 8159 children in 2002. No significant differences in current prevalence of asthma and asthma medication was found in 6-7 year olds and 13-14 year old girls. Significantly less asthma and asthma medication was reported by 13-14 year old boys in 2002. Symptoms of wheeze had lower occurrence in all groups in 2002, which was significant for older age group. Current prevalence of rash was significantly higher in the 6-7 year olds in 2002. No such increase was found for rash in the older age groups but they reported significantly more rhinitis. No differences were found between urban and suburban Antwerp in either survey. No clear changes in the occurrence of asthma were found for school children in Antwerp while wheeze was reported less in 2002 compared to 1996. Allergic disorders had higher occurrences in schoolchildren in 2002.