Early exposure to infections and antibiotics and the incidence of allergic disease: a birth cohort study with the West Midlands General Practice Research Database. McKeever, T. M., Lewis, S. A., Smith, C., Collins, J., Heatlie, H., Frischer, M., & Hubbard, R. The Journal of Allergy and Clinical Immunology, 109(1):43--50, January, 2002. abstract bibtex BACKGROUND: It has been suggested that the rise in prevalence of allergic disease in westernized countries is due in part to a decrease in exposure to infections and an increase in the use of antibiotics early in life. OBJECTIVE: The purpose of this investigation was to quantify the relationships between (1) exposure to personal infections, infections in siblings, and use of antibiotics in early life and (2) the incidence of allergic disease. METHODS: Using the West Midlands section of the UK General Practice Research Database, we established a historical birth cohort of children (N = 29,238). For each child, we identified all personal infections and infections in siblings and determined the use of antibiotics in early life; we also noted incident diagnoses of asthma, eczema, and hay fever. The data were analyzed through use of Cox regression. RESULTS: There was no clear protective effect of exposure to either personal infections or infections in siblings with respect to the incidence of allergic disease. Antibiotic exposure was associated with an increased risk of developing allergic disease in a dose-related manner: having 4 or more courses of antibiotics in the first year of life was associated with an increased incidence of asthma (hazard ratio [HR], 3.13; 95% CI, 2.75-3.57), eczema (HR, 1.48; 95% CI, 1.31-1.68), and hay fever (HR, 2.12; 95% CI, 1.68-2.66). However, adjusting for consulting behavior reduced these effects (adjusted HR [95% CI]: asthma, 1.99 [1.72-2.31]; eczema, 1.01 [0.88-1.17]; hay fever, 1.14 [0.88-1.47]). CONCLUSIONS: We found no evidence that exposure to infections reduced the incidence of allergic disease, and infections did not explain the previous findings of a strong birth order effect in this cohort. The use of antibiotics might be associated with early diagnoses of allergic disease.
@article{mckeever_early_2002,
title = {Early exposure to infections and antibiotics and the incidence of allergic disease: a birth cohort study with the {West} {Midlands} {General} {Practice} {Research} {Database}},
volume = {109},
issn = {0091-6749},
shorttitle = {Early exposure to infections and antibiotics and the incidence of allergic disease},
abstract = {BACKGROUND: It has been suggested that the rise in prevalence of allergic disease in westernized countries is due in part to a decrease in exposure to infections and an increase in the use of antibiotics early in life.
OBJECTIVE: The purpose of this investigation was to quantify the relationships between (1) exposure to personal infections, infections in siblings, and use of antibiotics in early life and (2) the incidence of allergic disease.
METHODS: Using the West Midlands section of the UK General Practice Research Database, we established a historical birth cohort of children (N = 29,238). For each child, we identified all personal infections and infections in siblings and determined the use of antibiotics in early life; we also noted incident diagnoses of asthma, eczema, and hay fever. The data were analyzed through use of Cox regression.
RESULTS: There was no clear protective effect of exposure to either personal infections or infections in siblings with respect to the incidence of allergic disease. Antibiotic exposure was associated with an increased risk of developing allergic disease in a dose-related manner: having 4 or more courses of antibiotics in the first year of life was associated with an increased incidence of asthma (hazard ratio [HR], 3.13; 95\% CI, 2.75-3.57), eczema (HR, 1.48; 95\% CI, 1.31-1.68), and hay fever (HR, 2.12; 95\% CI, 1.68-2.66). However, adjusting for consulting behavior reduced these effects (adjusted HR [95\% CI]: asthma, 1.99 [1.72-2.31]; eczema, 1.01 [0.88-1.17]; hay fever, 1.14 [0.88-1.47]).
CONCLUSIONS: We found no evidence that exposure to infections reduced the incidence of allergic disease, and infections did not explain the previous findings of a strong birth order effect in this cohort. The use of antibiotics might be associated with early diagnoses of allergic disease.},
language = {eng},
number = {1},
journal = {The Journal of Allergy and Clinical Immunology},
author = {McKeever, Tricia M. and Lewis, Sarah A. and Smith, Chris and Collins, Juliet and Heatlie, Heath and Frischer, Martin and Hubbard, Richard},
month = jan,
year = {2002},
pmid = {11799364},
keywords = {Anti-Bacterial Agents, Child, Child, Preschool, Cohort Studies, Family Practice, Female, Humans, Hypersensitivity, Infant, Male, Prospective Studies, databases as topic, incidence, infection},
pages = {43--50}
}
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A.","Smith, C.","Collins, J.","Heatlie, H.","Frischer, M.","Hubbard, R."],"year":2002,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"Early exposure to infections and antibiotics and the incidence of allergic disease: a birth cohort study with the West Midlands General Practice Research Database","volume":"109","issn":"0091-6749","shorttitle":"Early exposure to infections and antibiotics and the incidence of allergic disease","abstract":"BACKGROUND: It has been suggested that the rise in prevalence of allergic disease in westernized countries is due in part to a decrease in exposure to infections and an increase in the use of antibiotics early in life. OBJECTIVE: The purpose of this investigation was to quantify the relationships between (1) exposure to personal infections, infections in siblings, and use of antibiotics in early life and (2) the incidence of allergic disease. METHODS: Using the West Midlands section of the UK General Practice Research Database, we established a historical birth cohort of children (N = 29,238). For each child, we identified all personal infections and infections in siblings and determined the use of antibiotics in early life; we also noted incident diagnoses of asthma, eczema, and hay fever. The data were analyzed through use of Cox regression. RESULTS: There was no clear protective effect of exposure to either personal infections or infections in siblings with respect to the incidence of allergic disease. Antibiotic exposure was associated with an increased risk of developing allergic disease in a dose-related manner: having 4 or more courses of antibiotics in the first year of life was associated with an increased incidence of asthma (hazard ratio [HR], 3.13; 95% CI, 2.75-3.57), eczema (HR, 1.48; 95% CI, 1.31-1.68), and hay fever (HR, 2.12; 95% CI, 1.68-2.66). However, adjusting for consulting behavior reduced these effects (adjusted HR [95% CI]: asthma, 1.99 [1.72-2.31]; eczema, 1.01 [0.88-1.17]; hay fever, 1.14 [0.88-1.47]). CONCLUSIONS: We found no evidence that exposure to infections reduced the incidence of allergic disease, and infections did not explain the previous findings of a strong birth order effect in this cohort. The use of antibiotics might be associated with early diagnoses of allergic disease.","language":"eng","number":"1","journal":"The Journal of Allergy and Clinical Immunology","author":[{"propositions":[],"lastnames":["McKeever"],"firstnames":["Tricia","M."],"suffixes":[]},{"propositions":[],"lastnames":["Lewis"],"firstnames":["Sarah","A."],"suffixes":[]},{"propositions":[],"lastnames":["Smith"],"firstnames":["Chris"],"suffixes":[]},{"propositions":[],"lastnames":["Collins"],"firstnames":["Juliet"],"suffixes":[]},{"propositions":[],"lastnames":["Heatlie"],"firstnames":["Heath"],"suffixes":[]},{"propositions":[],"lastnames":["Frischer"],"firstnames":["Martin"],"suffixes":[]},{"propositions":[],"lastnames":["Hubbard"],"firstnames":["Richard"],"suffixes":[]}],"month":"January","year":"2002","pmid":"11799364","keywords":"Anti-Bacterial Agents, Child, Child, Preschool, Cohort Studies, Family Practice, Female, Humans, Hypersensitivity, Infant, Male, Prospective Studies, databases as topic, incidence, infection","pages":"43--50","bibtex":"@article{mckeever_early_2002,\n\ttitle = {Early exposure to infections and antibiotics and the incidence of allergic disease: a birth cohort study with the {West} {Midlands} {General} {Practice} {Research} {Database}},\n\tvolume = {109},\n\tissn = {0091-6749},\n\tshorttitle = {Early exposure to infections and antibiotics and the incidence of allergic disease},\n\tabstract = {BACKGROUND: It has been suggested that the rise in prevalence of allergic disease in westernized countries is due in part to a decrease in exposure to infections and an increase in the use of antibiotics early in life.\nOBJECTIVE: The purpose of this investigation was to quantify the relationships between (1) exposure to personal infections, infections in siblings, and use of antibiotics in early life and (2) the incidence of allergic disease.\nMETHODS: Using the West Midlands section of the UK General Practice Research Database, we established a historical birth cohort of children (N = 29,238). For each child, we identified all personal infections and infections in siblings and determined the use of antibiotics in early life; we also noted incident diagnoses of asthma, eczema, and hay fever. The data were analyzed through use of Cox regression.\nRESULTS: There was no clear protective effect of exposure to either personal infections or infections in siblings with respect to the incidence of allergic disease. Antibiotic exposure was associated with an increased risk of developing allergic disease in a dose-related manner: having 4 or more courses of antibiotics in the first year of life was associated with an increased incidence of asthma (hazard ratio [HR], 3.13; 95\\% CI, 2.75-3.57), eczema (HR, 1.48; 95\\% CI, 1.31-1.68), and hay fever (HR, 2.12; 95\\% CI, 1.68-2.66). However, adjusting for consulting behavior reduced these effects (adjusted HR [95\\% CI]: asthma, 1.99 [1.72-2.31]; eczema, 1.01 [0.88-1.17]; hay fever, 1.14 [0.88-1.47]).\nCONCLUSIONS: We found no evidence that exposure to infections reduced the incidence of allergic disease, and infections did not explain the previous findings of a strong birth order effect in this cohort. The use of antibiotics might be associated with early diagnoses of allergic disease.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {The Journal of Allergy and Clinical Immunology},\n\tauthor = {McKeever, Tricia M. and Lewis, Sarah A. and Smith, Chris and Collins, Juliet and Heatlie, Heath and Frischer, Martin and Hubbard, Richard},\n\tmonth = jan,\n\tyear = {2002},\n\tpmid = {11799364},\n\tkeywords = {Anti-Bacterial Agents, Child, Child, Preschool, Cohort Studies, Family Practice, Female, Humans, Hypersensitivity, Infant, Male, Prospective Studies, databases as topic, incidence, infection},\n\tpages = {43--50}\n}\n\n","author_short":["McKeever, T. M.","Lewis, S. 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