■调查美国成年人抗生素暴露与哮喘之间的关系。
■数据来自1999年至2018年进行的国家健康和营养检查调查(NHANES)。共有51,124名参与者参加,不包括年龄<20岁的人,怀孕的女性参与者,以及未完成有关哮喘状况的处方药调查问卷和医疗状况调查问卷的个体.抗生素暴露被定义为过去30天内抗生素的使用,基于MultumLexiconPlus治疗分类系统进行分类。哮喘被定义为在过去一年中有哮喘病史或有哮喘发作或喘息症状。
■发现哮喘的风险为2.557(95%CI:1.811,3.612),1.547(95%CI:1.190,2.011)和2.053(95%CI:1.344,3.137)倍于使用大环内酯衍生物的参与者,青霉素和喹诺酮类药物在过去30天,分别,与那些不使用抗生素的人相比。在调整人口统计学协变量和哮喘相关因素后,在20-40岁和40-60岁年龄组中,只有大环内酯类衍生物与哮喘显著相关.对于60岁以上的人来说,喹诺酮类药物与哮喘显著相关.不同类型的抗生素对哮喘的影响在男性和女性人群中有所不同。此外,更高的社会经济地位,更大的BMI,年龄较小,吸烟习惯,感染史,慢性支气管炎,肺气肿,哮喘家族史均被确定为哮喘的危险因素.
■我们的研究表明,在人群的不同亚组中,三种类型的抗生素与哮喘显着相关。因此,抗生素的使用应该受到更严格的监管。
To investigate the relationship between antibiotic exposure and asthma in adults in the United States.
Data was obtained from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999 and 2018. A total of 51,124 participants were included, excluding those who were aged < 20 years, female participants who were pregnant, and individuals who did not complete the prescription medications questionnaire and the medical conditions questionnaire regarding asthma status. Antibiotic exposure was defined as the utilization of antibiotics within the past 30 days, categorized based on the Multum Lexicon Plus therapeutic classification system. Asthma was defined as having a history of asthma or having an asthma attack or wheezing symptoms in the past year.
The risk of asthma was found to be 2.557 (95% CI: 1.811, 3.612), 1.547 (95% CI: 1.190, 2.011) and 2.053 (95% CI: 1.344, 3.137) times greater in participants who had used macrolide derivatives, penicillin and quinolones in the past 30 days, respectively, compared with those not using antibiotics. After adjusting for demographic covariates and asthma-related factors, only macrolides derivatives were significantly associated with asthma in the 20-40 and 40-60 age groups. For individuals over 60 years old, quinolones were significantly associated with asthma. The effect of different types of antibiotic with asthma varied in male and female populations. Moreover, higher socioeconomic status, greater BMI, younger age, smoking habits, history of infection, chronic bronchitis, emphysema, and family history of asthma were all identified as risk factors for asthma.
Our study indicated that three types of antibiotics were significantly associated with asthma in different subgroups of the population. Therefore, the use of antibiotics should be more strictly regulated.