Meta-analysis of early-life antibiotic use and allergic rhinitis
Liu Xiang,
Wu Rongrong,
Fu Yong,
Chen Wenxin,
Chen Yang,
Yan Yangyan,
Bi Jing,
Liu Jia
Affiliations
Liu Xiang
Department of ENT and Head & Neck Surgery, Hangzhou First Hospital Affiliated to Zhejiang University School of Medicine, Hangzhou, 310003, Zhejiang, China
Wu Rongrong
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
Fu Yong
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
Chen Wenxin
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
Chen Yang
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
Yan Yangyan
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
Bi Jing
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
Liu Jia
Department of ENT and Head & Neck Surgery, The Children’s Hospital Zhejiang University School of Medicine, 3333 Bingsheng Road, Hangzhou, 310051, Zhejiang, China
This meta-analysis aimed to investigate the correlation between early-life antibiotic use and allergic rhinitis. PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched for available studies. Eighteen studies covering 1,768,874 children were included. Early-life antibiotics were associated with an increased incidence of allergic rhinitis (effect size (ES) = 5.00, 95% confidence interval [CI]: 4.88–5.13; I 2 = 95.7%, P heterogeneity <0.001). In Asia, Europe, and the USA, the incidence of allergic rhinitis in the antibiotic group was higher than that in the no medication group (Asia: ES = 3.68, 95% CI: 3.38–4.01; Europe: ES = 3.20, 95% CI: 3.00–3.42; USA: ES = 3.68, 95% CI: 2.74–4.95). Compared with the no medication group, children who received antibiotics in the first 1 week of life (ES = 5.75, 95% CI: 2.18–15.18), first 1 year of life (ES = 3.37, 95% CI: 3.20–3.55; I 2 = 64.2%, P heterogeneity = 0.001), or first 3 years of life (ES = 5.21, 95% CI: 2.42–11.19) had a higher incidence of allergic rhinitis. No individual study influenced the estimates of the meta-analysis. The funnel plot showed moderate symmetry and low publication bias. In conclusion, the use of antibiotics in early life was associated with allergic rhinitis. Still, most included studies analyzed antibiotic exposure as a dichotomous variable, without information on the type and dosage of antibiotics.
