Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study

Background Overuse and misuse of antibiotics is a public health problem in low-income and middle-income countries. Although the association of antibiotics with atopic and allergic diseases has been established, most studies focused on prenatal exposure and the occurrence of disease in infants or you...

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Main Authors: Jie Li, Bin Wu, Yi Xiao, Xiaohui Wang, Juan Tao, Xiang Chen, Shijun Shan, Juan Su, Minxue Shen, Yajia Li, Danrong Jing, Yuzhou Huang, Ji Li, Xiaojing Kang
Format: Article
Language:English
Published: BMJ Publishing Group 2021-09-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/9/e047768.full
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author Jie Li
Bin Wu
Yi Xiao
Xiaohui Wang
Juan Tao
Xiang Chen
Shijun Shan
Juan Su
Minxue Shen
Yajia Li
Danrong Jing
Yuzhou Huang
Ji Li
Xiaojing Kang
author_facet Jie Li
Bin Wu
Yi Xiao
Xiaohui Wang
Juan Tao
Xiang Chen
Shijun Shan
Juan Su
Minxue Shen
Yajia Li
Danrong Jing
Yuzhou Huang
Ji Li
Xiaojing Kang
author_sort Jie Li
collection DOAJ
description Background Overuse and misuse of antibiotics is a public health problem in low-income and middle-income countries. Although the association of antibiotics with atopic and allergic diseases has been established, most studies focused on prenatal exposure and the occurrence of disease in infants or young children.Objective To investigate the association of preschool use of antibiotics with atopic and allergic skin diseases in young adulthood.Design Population-based retrospective cohort.Setting and participants The first-year college students (n=20 123) from five universities were investigated. The sampled universities are located in Changsha, Wuhan, Xiamen, Urumqi and Hohhot, respectively.Methods We conducted a dermatological field examination and a questionnaire survey inquiring the participants about the frequency of upper respiratory tract infection (URTI) and the preschool antibiotics use (prior to 7 years old). The two-level probit model was used to estimate the associations, and adjusted risk ratio (aRR) and 95% CI were presented as the effect size.Results A total of 20 123 participants with complete information was included in the final analysis. The frequent antibiotics use intravenously (aRR 1.36, 95% CI 1.14 to 1.62) and orally (aRR 1.18, 95% CI 1.01 to 1.38) prior to 7 years old was significantly associated with atopic dermatitis in young adulthood. Similar trends could be observed in allergic skin diseases among those who use antibiotics orally and intravenously, with RRs of 1.16 (95% CI 1.01 to 1.34) and 1.33 (95% CI 1.13 to 1.57), respectively.Conclusions Preschool URTI and antibiotics use significantly increases the risk of atopic and allergic skin diseases in young adulthood.
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spelling doaj-art-e8e912b6683e474cbb5deecbdbb5ed582025-08-20T02:17:57ZengBMJ Publishing GroupBMJ Open2044-60552021-09-0111910.1136/bmjopen-2020-047768Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort studyJie Li0Bin Wu1Yi Xiao2Xiaohui Wang3Juan Tao4Xiang Chen5Shijun Shan6Juan Su7Minxue Shen8Yajia Li9Danrong Jing10Yuzhou Huang11Ji Li12Xiaojing Kang13Guangdong Provincial Clinical Research Center for Obstetrical and Gynecological Diseases, Guangzhou, Guangdong, ChinaDepartment of Pediatrics, First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China4 Furong Laboratory, Changsha, Hunan, ChinaDepartment of Social Medicine and Health Management, School of Public Health, Lanzhou University, Lanzhou, Gansu Province, ChinaDepartment of Dermatology, Affiliated Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaDepartment of Dermatology; Hunan Engineering Research Center of Skin Health and Disease; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, ChinaDepartment of Dermatology, Xiang’an Hospital, Xiamen University, Xiamen, China3 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, China3 National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Dermatology; Hunan Engineering Research Center of Skin Health and Disease; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, China1 Department of Dermatology | Hunan Engineering Research Center of Skin Health and Disease | Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, Hunan, ChinaDepartment of Dermatology; Hunan Engineering Research Center of Skin Health and Disease; Hunan Key Laboratory of Skin Cancer and Psoriasis, Xiangya Hospital, Central South University, Changsha, ChinaSchool of Disaster and Emergency Medicine, Tianjin University, Tianjin, ChinaDepartment of Dermatology, People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, ChinaBackground Overuse and misuse of antibiotics is a public health problem in low-income and middle-income countries. Although the association of antibiotics with atopic and allergic diseases has been established, most studies focused on prenatal exposure and the occurrence of disease in infants or young children.Objective To investigate the association of preschool use of antibiotics with atopic and allergic skin diseases in young adulthood.Design Population-based retrospective cohort.Setting and participants The first-year college students (n=20 123) from five universities were investigated. The sampled universities are located in Changsha, Wuhan, Xiamen, Urumqi and Hohhot, respectively.Methods We conducted a dermatological field examination and a questionnaire survey inquiring the participants about the frequency of upper respiratory tract infection (URTI) and the preschool antibiotics use (prior to 7 years old). The two-level probit model was used to estimate the associations, and adjusted risk ratio (aRR) and 95% CI were presented as the effect size.Results A total of 20 123 participants with complete information was included in the final analysis. The frequent antibiotics use intravenously (aRR 1.36, 95% CI 1.14 to 1.62) and orally (aRR 1.18, 95% CI 1.01 to 1.38) prior to 7 years old was significantly associated with atopic dermatitis in young adulthood. Similar trends could be observed in allergic skin diseases among those who use antibiotics orally and intravenously, with RRs of 1.16 (95% CI 1.01 to 1.34) and 1.33 (95% CI 1.13 to 1.57), respectively.Conclusions Preschool URTI and antibiotics use significantly increases the risk of atopic and allergic skin diseases in young adulthood.https://bmjopen.bmj.com/content/11/9/e047768.full
spellingShingle Jie Li
Bin Wu
Yi Xiao
Xiaohui Wang
Juan Tao
Xiang Chen
Shijun Shan
Juan Su
Minxue Shen
Yajia Li
Danrong Jing
Yuzhou Huang
Ji Li
Xiaojing Kang
Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
BMJ Open
title Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
title_full Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
title_fullStr Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
title_full_unstemmed Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
title_short Association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood: a population-based retrospective cohort study
title_sort association of antibiotics use in preschool age with atopic and allergic skin diseases in young adulthood a population based retrospective cohort study
url https://bmjopen.bmj.com/content/11/9/e047768.full
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