Antibiotic overuse and allergy-related diseases: an epidemiological cross-sectional study in the grasslands of Northern China

Abstract

Background

Several studies have shown that the use of antibiotics early in life significantly increases the risk of asthma in children. It is unclear whether antibiotics are more commonly used in patients with allergy-related diseases.

Methods

A multistage, clustered and random sampling with a field-interviewer-administrated survey study was performed to investigate if there was multiple use of antibiotics (MUA) in patients with allergic rhinitis (AR), conjunctivitis, chronic urticaria (CU), and asthma in the grasslands of northern China. MUA was defined as antibiotic usage for at least 3 days and for more than 3 times a year in the past 2 years.

Results

A total of 5,787 subjects completed the study, with 1,079 subjects (18.6%) identified as MUA. MUA was more common in patients with AR (23.7% vs 16.2%, P<0.001), conjunctivitis (22.5% vs 17.1%, P<0.001), asthma (31.8% vs 17.7%, P<0.001), and CU (25.9% vs 18.3%, P<0.01) than in subjects without allergic diseases. There is an increasing percentage of MUA in patients with a single, two, and three or more diseases both in children (20.1%, 25.0%, and 31.4%, respectively, P=0.014) and in adults (19.1%, 23.4%, and 32.9%, respectively, P<0.001). MUA is significantly associated with AR (OR=1.7, 95% CI: 1.3–2.1, P<0.001), conjunctivitis (OR=1.6, 95% CI: 1.2–2.1, P=0.001), asthma (OR=2.3, 95% CI:1.6–3.3, P<0.001) and CU (OR=2.1, 95% CI: 1.2–3.6, P=0.006) in children aged 2–17 years; and in adults (≥18 years old) for AR (OR=1.7, 95% CI: 1.4–2.1, P<0.001), conjunctivitis (OR=1.3, 95% CI:1.1–1.6, P=0.002), and asthma (OR=2.0, 95% CI: 1.5–2.7, P<0.001).

Conclusion

Antibiotic overuse might be associated with increased risk of allergy-related disease. It is important that implementation of the evidence-based international guidelines for the management of allergy-related diseases needs to be improved, in order to avoid unnecessary use of antibiotics.

Keywords:

• allergic rhinitis
• conjunctivitis
• chronic urticaria
• asthma
• antibiotics
• epidemiology

Acknowledgments

This study was supported by the National Key Specialty Funding of China (health and Family Planning Commission-16) and Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support (ZYLX201826).

Ethical approval

Approval to conduct this study was granted by the institutional review boards of Beijing Shijitan Hospital, the affiliated hospital of the Beijing Capital Medical University, and of all six participating municipalities. All respondents signed informed consent.

Disclosure

The authors report no conflicts of interest in this work.