Antibiotic use in 1-week-olds linked to raised asthma risk at age 6 years

Key takeaways:

• Included children had mothers with a positive group B Streptococcus vaginal culture.
• The link between postnatal antibiotic use and asthma risk was observed in two models.

SAN DIEGO — A link between antibiotic use for a maternal indication in 1-week-olds and an elevated risk for asthma at 6 years old has been discovered, according to a presentation here.

This population-based study was presented at the 2025 American Academy of Allergy, Asthma and Immunology/World Allergy Organization Joint Congress.

“The findings strengthen and further clarify the association between early antibiotic exposure and the development of childhood asthma,” Eyal Kristal, MD, pediatrician specializing in allergy and clinical immunology at Soroka University Medical Center in Israel, told Healio.

Using data on births between 2006 and 2018, Kristal and colleagues evaluated 14,807 healthy, full-term offspring who had mothers with a positive group B Streptococcus vaginal culture to determine the relationship between antibiotic treatment for a maternal indication in 1-week-olds and risk for asthma at age 6 years.

Notably, this study did not contain offspring who had postnatal respiratory symptoms/pneumonia or positive blood/cerebrospinal fluid cultures, according to the abstract.

Within this population, 311 offspring had been treated with antibiotics at 1 week old, whereas the remaining offspring had not been treated with antibiotics at this age.

Following adjustment for several covariates (“ethnicity, mode of delivery, birth weight, gender, maternal asthma, maternal antibiotic use during pregnancy and socioeconomic status”), researchers observed a significant heightened risk for asthma at age 6 years among the offspring who received vs. did not receive antibiotic treatment (RR = 1.3; 95% CI, 1.04-1.6).

After propensity score matching the offspring treated with antibiotics to the offspring not treated with antibiotics based on the above covariates in a 1:3 ratio, researchers again found that the risk for asthma at age 6 years was elevated in the group treated with antibiotics (RR = 1.31; 95% CI, 1.01-1.69). The abstract noted that this finding validated the relationship.

In addition to the risk for childhood asthma, there was a significant link found between short-acting beta agonist use and postnatal antibiotic treatment (P = .043), as well as between allergic rhinitis and postnatal antibiotic treatment (P = .011).

Kristal told Healio these findings highlight “the need for educational programs to reduce improper or careless use of antibiotics.”

Reference:

• Isolated early-life antibiotic exposure is associated with increased risk of childhood asthma. https://www.aaaai.org/about/news/news/2025/antibiotic. Published Feb. 10, 2025. Accessed Feb. 10, 2025.

For more information:

Eyal Kristal, MD, can be reached at kristal@post.bgu.ac.il.