Often the clinical picture of respiratory tract infections in young children can be difficult to distinguish from the first symptoms of bronchial asthma; therefore, in a number of studies on bronchial asthma, antibiotic therapy has been prescribed. The early onset of antibiotic therapy, in particular the appointment of broad-spectrum antibacterial drugs, inhibits the development of the immune system and thus contributes to the formation of an insufficient anti-allergic response.

When prescribing antibacterial therapy, especially in children, a healthy approach is necessary, especially when it comes to broad spectrum drugs. It is becoming clear why there is concern about a review of the clinical guidelines for antibiotic therapy for acute otitis media in Canada and the United States that broad spectrum antibiotics are preferred.

For the period from 2003 to 2007 in a cohort study (n = 1401), scientists determined the relationship between antibiotic therapy during the first 6 months of life and the development of bronchial asthma or another allergopathology after the age of 6 years. As the results of the study showed, taking antibacterial drugs was directly associated with an increased risk of developing bronchial asthma (correlated odds ratio 1.52, 95% confidence interval 1.07 -2.16). In children with bronchial asthma already detected at 3 years of age, the odds ratio was 1.66 (95% confidence interval: 0.99, 2.79), and in children who did not 'had no history of lower respiratory tract infections during the first year of life, the odds ratio was 1.66 (95% confidence interval 1.12-3.46). The estimated adverse effect of antibiotic therapy was particularly pronounced in children who had no family history of asthma (odds ratio of 1.89, 95% confidence interval 1.00-3.58, p = 0.03). The odds ratio for a positive skin test or ELISA for specific IgE was 1.59 (95% confidence interval 1.10-2.28).

The limitations of this study were the characteristics of the data collection: information on the use of antibiotics, as well as on the presence of bronchial asthma and the results of skin tests, was collected on the basis of a survey. with mothers after the children have reached the age of 6 years. In addition, there is not enough information about the antibiotics prescribed. The reason lies in the complexity of the complete collection of information, because the parents simply did not pay attention to features such as the spectrum of antibiotic action.

In order to minimize the influence of "protopathic error" on the results, the scientists excluded from the study children with an established diagnosis of bronchial asthma less than 6 months old, that is to say in the period coinciding with the appointment of antibiotics. In addition, an independent analysis of children who did not have symptoms of lower respiratory tract infection was performed. At the same time, the authors did not consider separately the cases of antibiotic therapy due to an infection of a different localization, because the researchers did not have sufficient information on the indications for antibiotic therapy. But even if they had such information, the number of cases of prescription of antibiotics due to an infection of a different localization would be insufficient for a complete analysis.

Many reviews have found positive aspects. In particular, the indisputable advantages are the exhaustiveness of the collection of data on the characteristics of the evolution of pregnancy and the postpartum period, the authors' attempts to take into account "protopathic error" in the process interpretation of results, as well as deliberate differentiation of children with and without a charged family history. Currently, it is known with certainty that increased heredity in most cases determines the development of bronchial asthma in childhood. In addition, most genetic studies conducted to try to find specific genetic polymorphisms responsible for the development of bronchial asthma have failed.

Thus, the results obtained confirmed the link between the development of bronchial asthma or another allergopathology at the age of 6 years and the antibiotic therapy prescribed in early childhood, while "protopathic error" should not not be considered a significant factor that could significantly affect the results of the study.

In the future, it is recommended to conduct population-based prospective studies on a larger scale in order to obtain more precise information on the use of antibacterial drugs. This can be done using the official databases of prescribed drugs, taking into account the indications for antibiotic therapy. In addition, as the researchers note, special attention should be paid to the effect of antibiotic therapy on the condition of the gastrointestinal microflora and immunity in children, which in turn will help clarify the biological mechanisms of the effect of antibiotics on the development of bronchial asthma and other allergic diseases in children.