Do antibiotics cause asthma?

The first safe antibiotic hit the market in 1945, and it became an instant hit among physicians.  Sales of Penicillin spiked -- fast, and by the 1960s Penicillin became the fastest growing and most popular medicine of all time.

It was prescribed for everything.  If there was even a slim chance a bacteria was involved an antibiotic was prescribed.  People were surviving surgeries and illnesses that historically had high mortality rates.  The medicine was a godsend.

Yet then we learned that some bacteria can develop resistance to antibiotics.  And now we learn that antibiotics might cause asthma?  What?  Why?  This was the topic of a most recent post of mine over at MyAsthmaCentral.com.

Parents Beware!  Antibiotics May Cause Asthma, from MyAsthmaCentral, March 21, 2011

Parents and doctors beware! Antibiotic use during the first year of life probably does cause asthma!

There is enough research now that we can definitely say probably. General thinking for years has been that if a child has an infection it should be treated with antibiotics. Yet newer evidence is leaning in the direction that while antibiotics cure an acute infection, it may cause asthma later on.

The most recent study was completed by Yale University researchers, and they interviewed women during pregnancy and when the child was 6-years-old. Of the 1,401 studied:

• 40 percent of infants given just one dose of antibiotics developed childhood asthma and allergies.

• 70 percent of infants given two rounds of antibiotics developed asthma

These are pretty significant statistics, and they correlate well with past studies like this one completed in 2007 at the University of Manitoba and McGill University in Montreal.

Back then 13,116 infants were followed to age 7, and the conclusion was that infants who received antibiotics were at a much greater risk of developing asthma. Likewise, the more rounds of antibiotics the greater the risk.

At present there are two educated guesses that scientists are keeping an eye on to help explain this phenomenon:

Hygiene Hypothesis: Lack of exposure to bacteria causes your immune system to get bored and attack things that aren't supposed to be bad. Thus, newborns must be exposed to certain bacteria in order to develop properly. Since antibiotics kill the bacteria it needs to develop, such infants develop asthma.

Micro Flora Hypothesis: Lack of normal bacteria in the intestinal tract causes a response that leads to an increase in inflammatory markers, which then leads to asthma and allergies. Thus, certain antibiotics may wipe out the good bacteria along with the bad.

If we go by the Hygiene Hypothesis, all antibiotics should be avoided. However, if we go by the Micro Flora Hypothesis, it appears the main culprit is broad spectrum antibiotics such as erythromycin, azithromycin and clarithromycin.

Again, broad spectrum antibiotics wipe out the good bacteria with the bad. However, narrow spectrum antibiotics will target only the bacteria causing an infection.

So, in the past, a mom brings in an infant that is sick with nasal congestion, runny nose and an ear infection, the doctor would instantly thinks, "I have to do something. Since it takes 48 hours for cultures to get back, let's prescribe a broad spectrum antibiotic!  When cultures come back and we determine what specific bug is causing the problem, then we can switch to a narrow spectrum antibiotic."

Yet that thinking might have to change in lieu of modern wisdom. In the absence of a life threatening situation, it might be better to forgo the antibiotics and let kids under the age of one tough it out.

As a matter of fact, I presently have a child under a year in my house with eczema, and he developed an infection on his face. Yet knowing I have the asthma gene, we simply toughed it out -- just like they did in the olden days. And guess what? We all survived.

Rest assured, though, because there was already a plethora of evidence that antibiotics are over-prescribed. Consider the following:

Quite often antibiotics don't do any good anyway


Many infections are viral and not bacterial (antibiotics do nothing for viral infections)
Many times doctors have no clue what's causing the infection, yet antibiotics are ordered anyway (broad spectrum).

Many times antibiotics are only prescribed so mom's think something is being done
Or sometimes they're ordered just so the doctor can make sure he covers all his bases
Likewise, abuse of antibiotics has lead to antibiotic resistant bacteria

So the bottom line here is antibiotics may not even be necessary for your infant anyway. If they're in need then they should be used.  But just beware! Antibiotics may, cause asthma.
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