Early-Life Exposure to Oral Antibiotics and Lung Function Into Early Adulthood

To examine the association between early-life exposure to antibiotics and lung function and to assess whether antibiotic use puts children with mutations of the glutathione S-transferase (GST) superfamily at greater risk of developing lung function impairment.

This study included 620 infants with a family history of allergy from the Melbourne Atopy Cohort Study in Australia.

This study collected parent-reported data via telephone questionnaire of antibiotic use from birth to 2 years of age including indication, type, and duration. At ages 12 and 18 years, spirometry was performed as well as additional clinical examinations and questionnaires. Genotyping was performed at the 18-year follow-up for GST-P, GST-M, and GST-T polymorphisms. Outcome measures included forced expiratory vol at one second (FEV₁) and forced vital capacity (FVC) reported as z scores. Antibiotic exposure and lung function associations were analyzed using multiple linear regression models.

Increased exposure to antibiotics within the first two years of life was not associated with decreased lung function at either the 12- or 18-year time point, regardless of type and duration of antibiotic. GST mutations were not found to modify the associations between antibiotic exposure and lung function.

This study found that early-life exposure to antibiotics, regardless of duration, type, and younger age at first exposure was not associated with decreased lung function at 12 and 18 years of age. Lung function in children with GST null genotypes were not found to be negatively affected by antibiotic exposure.

This study is the first to measure associations between early-life antibiotic exposure and lung function, finding that increased oral antibiotic use in the first 2 years of life does not affect lung function. Although there was no significant association found, the over-administration of antibiotics and concern for antibiotic resistance are still of great importance and caution should continue to be used when prescribing antibiotics to children.