Antibiotic overuse and allergy-related diseases: an epidemiological cross-sectional study in the grasslands of Northern China
Received 1 February 2019
Accepted for publication 17 May 2019
Published 21 June 2019 Volume 2019:15 Pages 783—789
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Ms Justinn Cochran
Peer reviewer comments 3
Editor who approved publication: Professor Garry Walsh
Yan Lei Chen,1 Weirong Joshua Sng,2 De Yun Wang,2 Xue Yan Wang1
1Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, People’s Republic of China; 2Department of Otolaryngology, National University Health System, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
Background: Several studies have shown that the use of antibiotics early in life significantly increases the risk of asthma in children. It is unclear whether antibiotics are more commonly used in patients with allergy-related diseases.
Methods: A multistage, clustered and random sampling with a field-interviewer-administrated survey study was performed to investigate if there was multiple use of antibiotics (MUA) in patients with allergic rhinitis (AR), conjunctivitis, chronic urticaria (CU), and asthma in the grasslands of northern China. MUA was defined as antibiotic usage for at least 3 days and for more than 3 times a year in the past 2 years.
Results: A total of 5,787 subjects completed the study, with 1,079 subjects (18.6%) identified as MUA. MUA was more common in patients with AR (23.7% vs 16.2%, P<0.001), conjunctivitis (22.5% vs 17.1%, P<0.001), asthma (31.8% vs 17.7%, P<0.001), and CU (25.9% vs 18.3%, P<0.01) than in subjects without allergic diseases. There is an increasing percentage of MUA in patients with a single, two, and three or more diseases both in children (20.1%, 25.0%, and 31.4%, respectively, P=0.014) and in adults (19.1%, 23.4%, and 32.9%, respectively, P<0.001). MUA is significantly associated with AR (OR=1.7, 95% CI: 1.3–2.1, P<0.001), conjunctivitis (OR=1.6, 95% CI: 1.2–2.1, P=0.001), asthma (OR=2.3, 95% CI:1.6–3.3, P<0.001) and CU (OR=2.1, 95% CI: 1.2–3.6, P=0.006) in children aged 2–17 years; and in adults (≥18 years old) for AR (OR=1.7, 95% CI: 1.4–2.1, P<0.001), conjunctivitis (OR=1.3, 95% CI:1.1–1.6, P=0.002), and asthma (OR=2.0, 95% CI: 1.5–2.7, P<0.001).
Conclusion: Antibiotic overuse might be associated with increased risk of allergy-related disease. It is important that implementation of the evidence-based international guidelines for the management of allergy-related diseases needs to be improved, in order to avoid unnecessary use of antibiotics.
Keywords: allergic rhinitis, conjunctivitis, chronic urticaria, asthma, antibiotics, epidemiology
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