Over the past three decades, the incidence of bronchial asthma has increased in Western countries, and an increase in incidence appears to accompany the more frequent use of antibiotics in children. A study has been conducted to assess the relationship between the use of antibiotics in the first year of life and the development of asthma in children. The meta-analysis included studies published in the English literature of 1966, in which children received one or more cycles of antibiotics during the first year of life, and a diagnosis of bronchial asthma was made between 1 and 18 years old. A total of 8 works were included, including 4 prospective and 4 retrospective. By comparing the risk of developing bronchial asthma in children receiving and not receiving antibiotics, information was analyzed on 12082 children and 1817 cases of bronchial asthma. The dose-dependent analysis included information on 27,167 patients and 3,392 cases of bronchial asthma.

The generalized odds ratio (OR) in eight studies was 2.05 (95% confidence interval [CI] 1.41-2.99). The relationship was significantly stronger in retrospective studies (OR 2.82; 95% CI 2.07-3.85) than in prospective studies (OR 1.12; 95% CI 0.88-1.42).

Five out of eight studies have assessed the dependence of the risk of developing asthma on the number of antibiotics received during the first year of life. The overall odds ratio in the dose-response analysis was 1.16 (95% CI 1.05-1.28) for each additional antibiotic cycle. This relationship was not significantly stronger in retrospective studies (OR 1.37; 95% CI 1.18-1.60) compared to prospective studies (OR 1.07; 95% CI 0.95-1, 20).

It is possible that the results can be explained by reverse causation or by the fact that the indications for prescription of antibiotics acted as interfering factors, that is to say that children with asthma more often developed respiratory infections, and therefore antibiotics were used more often.

Thus, the conduct of one or more antibiotic treatments during the first year of a child's life can be a risk factor for asthma. There may be a dose-dependent effect, that is, the risk of asthma increases with the increase in the number of treatments administered. Due to the limitations of the work to date, additional large-scale prospective studies are needed to confirm the described relationship.