Antibiotic consumption in children prior to diagnosis of asthma

Using population-based data, 128,872 children were identified with at least 6 years of follow-up. The adjusted rate-ratio (RR) of antibiotics dispensed to asthmatic as compared to non-asthmatic children was determined.At age six, the RR of antibiotic consumption for asthmatics compared to non-asthmatics varied between, 1.66 to 2.32, depending on the year of asthma diagnosis. Of the 18,864 children with asthma at ages 2-8, 52% (n = 9,841) had antibiotics dispensed in the 6 months prior to their index date of asthma diagnosis. The RR of antibiotic consumption in the 1 month prior to asthma diagnosis compared to 5 months prior was 1.66 (95% CI 1.60-1.71). The RR was lower in males compared to females (1.58 vs 1.77), and lower in those who received antibiotics in the first year of life relative to those that did not (1.60 vs. 1.76).There is higher antibiotic consumption in children with asthma compared to those without asthma. The pattern of antibiotic use suggests that diagnosis guidelines are difficult to follow in young children leading to misdiagnosis and over treatment with antibiotics.Studies performed in varying populations over the last 30 years have indicated that the prevalence of asthma has significantly increased [1,2]. Asthma rates are particularly high in children with one in eight school children being affected [3]. Asthma is difficult to diagnose - particularly in children as frequently their only symptom is coughing which may be mistaken for an upper respiratory tract infection in addition to the fact that they cannot participate in many of the standard diagnostic tests. The North American guidelines [4,5] for pediatric asthma management outline a stepwise approach to asthma management with the aim being to initiate control of asthma with regular anti-inflammatory therapy and monitor the level of control by use of rescue medication as well as symptoms, and in older children with assessment of airflow obstruction [6,7]. As such, patients should start tre