Email updates

Keep up to date with the latest news and content from BMC Pulmonary Medicine and BioMed Central.

Open Access Research article

Antibiotic consumption in children prior to diagnosis of asthma

Fawziah Marra1*, Carlo A Marra2*, Kathryn Richardson3, Larry D Lynd4 and Mark J FitzGerald5

Author Affiliations

1 Professor, Faculty of Pharmaceutical Sciences, University of British Columbia; Director, Pharmacy and Vaccine Services, British Columbia Centre for Disease Control, Vancouver, B.C., Canada

2 Associate Professor and Director, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia; Scientist, Centre for Health Evaluation and Outcome Sciences, Providence Health Research Institute, Vancouver, B.C. Canada

3 Medical Statistician, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

4 Assistant Professor and Associate Director, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia; Scientist, Centre for Health Evaluation and Outcome Sciences, Providence Health Research Institute, Vancouver, B.C. Canada

5 Professor and Head, Division of Respiratory Medicine, Centre for Lung Health, Faculty of Medicine, University of British Columbia; Scientist, Centre for Clinical Epidemiology and Evaluation Vancouver Coastal Health Research Institute, Vancouver, B.C., Canada

For all author emails, please log on.

BMC Pulmonary Medicine 2011, 11:32  doi:10.1186/1471-2466-11-32

Published: 31 May 2011

Abstract

Background

Asthma is difficult to diagnose in children and at times misdiagnosis of an infection can occur. However, little is known about the magnitude and patterns of antibiotic consumption in children with asthma relative to those without asthma.

Methods

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.

Results

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).

Conclusions

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.