A Meta-analysis And Clinical Study On The Relationship Between Antibiotic Use Within 3 Years Old And Asthma In Children

ObjectiveMeta-analysis was conducted to evaluate whether antibiotic use within 3 years old was associated with the occurrence of childhood asthma.Then,a case-control study was conducted to verify whether the results of this meta-analysis are applicable to domestic children.It is helpful to standardize the rational use of antibiotics in children and provide guidance and reference for the prevention of asthma and the regulation of antibiotic use within 3 years old.Methods1.Part 1:Cohort studies and case-control studies on the correlation between antibiotic use within 3 years old and childhood asthma were searched from cnki database,Chinese journal of science and technology database,wanfang database,Chinese biomedical database（CBM）,Pubmed,Embase,Cochrane library and other Chinese and English databases.ReVman5.3 software was used.A meta-analysis was conducted to explore the relationship between antibiotic use within 3 years old and childhood asthma.2.Part 2:Children diagnosed with asthma in Shenyang Children’s Hospital from September 2019 to December 2021 were selected as the case group.At the same time,healthy children from the Child Health Care Department of Shenyang Children’s Hospital were selected as the control group with similar sex ratio and age.Questionnaire survey was conducted with reference to the International Study of Asthma and Allergy in Children（ISAAC）questionnaire.SPSS26.0 was used to analyze the relationship between each factor and asthma.Multivariate logistic regression model was used to analyze the relationship between antibiotic use within 3 years old and asthma in children.Results1.Part 1:Meta-analysis of 15 high-quality studies in this study showed that antibiotic use within 3 years old increased the risk of asthma in children（OR=1.63,95%CI:1.45-1.84,P<0.00001）.Antibiotics>4 times of antibiotic use within 3 years increased the risk of asthma in children（OR=1.63,95%CI:1.27-2.10,P=0.0001）,macrolides（OR=1.13,95%CI:1.06-1.21,P=0.0003）,cephalosporins（OR=1.11,95%CI:1.11,P=0.0003）.1.01-1.21,P=0.03)increased the risk of asthma in children.2.Part 2:40 children were included in the experimental group and the control group respectively.Analysis of exposure factors showed that preterm birth,eczema≥4 times and macrolide antibiotic use within 3 years old were considered risk factors.Conclusion1.Part 1:Antibiotic use within 3 years of age is a risk factor for childhood asthma.Antibiotic use>4 times is associated with increased risk of asthma in children.Macrolides and cephalosporins are risk factors of asthma in children among antibiotic use types,and penicillin needs further study.2.Part 2:Preterm birth,eczema≥4 times and macrolide within 3 years old are risk factors for asthma.However,due to the small sample size of this study,it can only explain the problem to a certain extent,and further increase of sample size is needed in the future.