Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study
Introduction Several studies have reported that exposure to antibiotics can lead to asthma during early childhood. However, the association between antibiotic use and risk of asthma in the adult population remains unclear. This study aimed to investigate the association between antibiotic use and as...
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BMJ Publishing Group
2023-07-01
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| Series: | BMJ Open Respiratory Research |
| Online Access: | https://bmjopenrespres.bmj.com/content/10/1/e001643.full |
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| author | Sang Min Park Jooyoung Chang Sung Min Kim Jiwon Choi Sun Jae Park Young Jun Park Jaeyi Hong Seogsong Jeong Jihun Song Yoosun Cho |
| author_facet | Sang Min Park Jooyoung Chang Sung Min Kim Jiwon Choi Sun Jae Park Young Jun Park Jaeyi Hong Seogsong Jeong Jihun Song Yoosun Cho |
| author_sort | Sang Min Park |
| collection | DOAJ |
| description | Introduction Several studies have reported that exposure to antibiotics can lead to asthma during early childhood. However, the association between antibiotic use and risk of asthma in the adult population remains unclear. This study aimed to investigate the association between antibiotic use and asthma in adults.Methods We used data from the National Health Insurance Service (NHIS)-Health Screening Cohort, which included participants aged ≥40 years who had health screening examination data in 2005–2006. A total of 248 961 participants with a mean age of 55.43 years were enrolled in this retrospective cohort study. To evaluate antibiotic exposure from the NHIS database for 5 years (2002–2006), cumulative usage and multiclass prescriptions were identified, respectively. During the follow-up period (2007–2019), 42 452 patients were diagnosed with asthma. A multivariate Cox proportional hazard regression model was used to assess the association between antibiotic use and newly diagnosed asthma.Results Participants with antibiotic use for ≥91 days showed a higher risk of asthma (adjusted HR (aHR) 1.84, 95% CI 1.72 to 1.96) compared with participants who did not use antibiotics (n=38 450), with a duration-dependent association (ptrend<0.001). Furthermore, ≥4 antibiotic class user group had an increased risk of asthma (aHR 1.44, 95% CI 1.39 to 1.49) compared with one class of antibiotic use (n=64 698). Also, one class of antibiotic use had a higher risk of asthma (aHR 1.21, 95% CI 1.17 to 1.26) compared with non-users, and it also showed a duration-dependent relationship in all classes, including 1, 2, 3 and ≥4 class group (ptrend<0.001). The duration-response relationship between antibiotic use and increased risk of asthma remained in our sensitivity analyses with the washout and shifting of the index date.Conclusions The duration-response pattern observed in antibiotic use and asthma may suggest the implication of proper antibiotic use and management in adults. |
| format | Article |
| id | doaj-art-3566580e70d8454ca334e0be30e07a07 |
| institution | DOAJ |
| issn | 2052-4439 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open Respiratory Research |
| spelling | doaj-art-3566580e70d8454ca334e0be30e07a072025-08-20T03:16:21ZengBMJ Publishing GroupBMJ Open Respiratory Research2052-44392023-07-0110110.1136/bmjresp-2023-001643Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort studySang Min Park0Jooyoung Chang1Sung Min Kim2Jiwon Choi3Sun Jae Park4Young Jun Park5Jaeyi Hong6Seogsong Jeong7Jihun Song8Yoosun Cho9Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of KoreaDepartment of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of KoreaLigChem Biosciences Inc., Daejeon, Republic of KoreaDepartment of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of KoreaDepartment of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of KoreaMedical Research Center, Genomic Medicine Institute, Seoul National University, Seoul, The Republic of KoreaDepartment of Statistics, University of Illinois at Urbana-Champaign, Urbana, Illinois, USADepartment of Biomedical Informatics, CHA University School of Medicine, Seongnam, The Republic of KoreaDepartment of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of KoreaTotal Healthcare Center, Kangbuk Samsung Hospital,Sungkyunkwan University School of Medicine, Seoul, The Republic of KoreaIntroduction Several studies have reported that exposure to antibiotics can lead to asthma during early childhood. However, the association between antibiotic use and risk of asthma in the adult population remains unclear. This study aimed to investigate the association between antibiotic use and asthma in adults.Methods We used data from the National Health Insurance Service (NHIS)-Health Screening Cohort, which included participants aged ≥40 years who had health screening examination data in 2005–2006. A total of 248 961 participants with a mean age of 55.43 years were enrolled in this retrospective cohort study. To evaluate antibiotic exposure from the NHIS database for 5 years (2002–2006), cumulative usage and multiclass prescriptions were identified, respectively. During the follow-up period (2007–2019), 42 452 patients were diagnosed with asthma. A multivariate Cox proportional hazard regression model was used to assess the association between antibiotic use and newly diagnosed asthma.Results Participants with antibiotic use for ≥91 days showed a higher risk of asthma (adjusted HR (aHR) 1.84, 95% CI 1.72 to 1.96) compared with participants who did not use antibiotics (n=38 450), with a duration-dependent association (ptrend<0.001). Furthermore, ≥4 antibiotic class user group had an increased risk of asthma (aHR 1.44, 95% CI 1.39 to 1.49) compared with one class of antibiotic use (n=64 698). Also, one class of antibiotic use had a higher risk of asthma (aHR 1.21, 95% CI 1.17 to 1.26) compared with non-users, and it also showed a duration-dependent relationship in all classes, including 1, 2, 3 and ≥4 class group (ptrend<0.001). The duration-response relationship between antibiotic use and increased risk of asthma remained in our sensitivity analyses with the washout and shifting of the index date.Conclusions The duration-response pattern observed in antibiotic use and asthma may suggest the implication of proper antibiotic use and management in adults.https://bmjopenrespres.bmj.com/content/10/1/e001643.full |
| spellingShingle | Sang Min Park Jooyoung Chang Sung Min Kim Jiwon Choi Sun Jae Park Young Jun Park Jaeyi Hong Seogsong Jeong Jihun Song Yoosun Cho Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study BMJ Open Respiratory Research |
| title | Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study |
| title_full | Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study |
| title_fullStr | Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study |
| title_full_unstemmed | Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study |
| title_short | Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study |
| title_sort | association between antibiotics and asthma risk among adults aged over 40 years a nationally representative retrospective cohort study |
| url | https://bmjopenrespres.bmj.com/content/10/1/e001643.full |
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