Furthermore, the extensive antibiotic use associated with better living conditions in Western countries could have been the initial factor in the discrepancy of allergy prevalence between industrialized and non-industrialized world. Epidemiological difference first likely corresponds with the time point around 20-25 years after initial extensive antibiotic exposure. This time point, in turn, corresponds to a rising prevalence start of respiratory allergies predominantly observed in industrialized countries, particularly over the last 35-40 years of the 20th century. Thus, von Mutius et al. have demonstrated that in genetically similar individuals, the prevalence of respiratory allergies was significantly higher among school children living in the former West (Munich) than children of former East Germany (Leipzig and Halle). Surprisingly, the mentioned east-west differences are observed only among children and younger adults but not among Germans born before the 1960s, suggesting that a “cohort effect” has been operating with the lifetime allergy risk under the influence of living conditions in early childhood. In parallel to Western Europe, significant increases in asthma morbidity in the USA have occurred since the 1970s, particularly among immigrants or African-American subjects. Compared to Western countries, the rising prevalence of atopic pathologies in the rest of the world is observed later. Several studies performed in tropical regions have provided further evidence that atopic disorders occur more commonly among individuals living in urban, more affluent, and westernized areas compared with those living in rural areas with traditional lifestyles.
Author(s) Details:
Alketa H. Bakiri
American Hospital of Tirana, Outpatients Allergology Service, Tirana, Albania and Faculty of Medical Sciences, Albanian University, Tirana, Albania.
Ervin Ç. Mingomataj
Department of Allergy & Clinical Immunology, “Mother Theresa” School of Medicine, Tirana, Albania.
Recent Global Research Developments in Antibiotics and Early Respiratory Atopy
Association of Early Viral Lower Respiratory Infections and Subsequent Development of Atopy:
A systematic review and meta-analysis investigated the relationship between childhood viral lower respiratory tract infections (LRTI) and the development of atopy [1].
Findings:
No association was observed between viral LRTI at <5 years and skin prick test-diagnosed atopy, unknown diagnosed atopy, atopic dermatitis, hyperreactivity to pollen, food, or house dust mite.
However, there was a relationship between childhood viral LRTI and serum test-diagnosed atopy, allergic rhinoconjunctivitis, hyperreactivity diagnosed by serum tests with food or inhaled allergens, and furred animals.
Impact of Antibiotic Allergy Labels:
A systematic review explored the effects of antibiotic allergy labels on antibiotic use, clinical outcomes, and healthcare costs [2].
Key findings:
Patients with antibiotic allergy labels received more broad-spectrum antibiotics.
Allergy-labeled patients had negative clinical outcomes (length of hospitalization, ICU admission, etc.).
Allergy labels led to higher drug or hospital-related costs.
Antibiotic Exposure and Lung Function:
Early-life exposure to oral antibiotics did not impair lung function in children with a family history of allergic diseases [3].
Neither increasing days of exposure nor earlier exposure to antibiotics affected lung function.
References
- Kenmoe S, Kengne-Nde C, Modiyinji AF, Bigna JJ, Njouom R (2020) Association of early viral lower respiratory infections and subsequent development of atopy, a systematic review and meta-analysis of cohort studies. PLoS ONE 15(4): e0231816. https://doi.org/10.1371/journal.pone.0231816
- Gerber, J. S., & Offit, B. F. (2021). Antibiotics for Acute Respiratory Tract Infections: Now, Later, or Never?. Pediatrics, 147(3).
- Dos Santos, K., Lodge, C. J., Abramson, M. J., Erbas, B., Bennett, C. M., Hui, J., … & Lowe, A. J. (2020). Early-life exposure to oral antibiotics and lung function into early adulthood. Chest, 157(2), 334-341.
