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. 2021 Nov 29;7(4):00429-2021.
doi: 10.1183/23120541.00429-2021. eCollection 2021 Oct.

The risk of respiratory tract infections and antibiotic use in a general population and among people with asthma

Marta A Kisiel  1 , Xingwu Zhou  2   3 , Eythor Björnsson  4 , Mathias Holm  5 , Anna Dahlman-Höglund  5 , Juan Wang  1 , Cecilie Svanes  6   7 , Dan Norbäck  1 , Karl A Franklin  8 , Andrei Malinovschi  3 , Ane Johannessen  6 , Vivi Schlünssen  9 , Christer Janson  2
Affiliations

The risk of respiratory tract infections and antibiotic use in a general population and among people with asthma

Marta A Kisiel et al. ERJ Open Res. .

Abstract

Aim: The aim of this study was to investigate occupational, environmental, early life and other risk factors associated with respiratory infections and antibiotics use in a general population and among asthmatic individuals.

Method: This study included 15 842 participants of the Respiratory Health in Northern Europe (RHINE) study aged 25-54 years from five Nordic countries, who answered a questionnaire covering respiratory outcomes, exposures, demographic characteristics and numbers of infections and courses of antibiotics in the last 12 months. Multiple logistic regression with and without adjustment for age, sex, smoking status, body mass index and centre were used to study the risk of infection and antibiotics in relation to asthma, and also the association between infection and antibiotics and occupations.

Results: In the whole population, 11.6% reported having three or more respiratory infections, and 14.7% had used antibiotics because of respiratory tract infections within the last year. Asthmatic participants reported tripled odds for such infections (adjusted OR 2.98, 95% CI 2.53-3.52) and antibiotics use (adjusted OR 3.67, 95% CI 3.18-4.24) as compared to non-asthmatic participants. Both in the general and the asthmatic population, female sex, obesity and exposure to building dampness were associated with respiratory infections. Female sex and current smoking and living in Tartu were associated with antibiotic use. The use of antibiotics was doubled in people hospitalised for severe respiratory infection in childhood.

Conclusion: In this study we identified several factors associated with increased respiratory infections and use of antibiotics in a general population and among asthmatic individuals. The frequency of respiratory infections and subsequent antibiotic treatment were increased among those with asthma.

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Conflict of interest statement

Conflict of interest: M.A. Kisiel has nothing to disclose. Conflict of interest: X. Zhou has nothing to disclose. Conflict of interest: E. Björnsson has nothing to disclose. Conflict of interest: M. Holm has nothing to disclose. Conflict of interest: A. Dahlman-Höglund has nothing to disclose. Conflict of interest: J. Wang has nothing to disclose. Conflict of interest: C. Svanes has nothing to disclose. Conflict of interest: D. Norbäck has nothing to disclose. Conflict of interest: K.A. Franklin has nothing to disclose. Conflict of interest: A. Malinovschi has nothing to disclose. Conflict of interest: A. Johannessen has nothing to disclose. Conflict of interest: V. Schlünssen has nothing to disclose. Conflict of interest: C. Janson has nothing to disclose.

Figures

FIGURE 1
FIGURE 1
The occurrence of self-reported respiratory tract infections (RTIs) (one to two times or three or more times or no infection) and the use of antibiotics for respiratory tract infections (at least once, no antibiotic) in the past 12 months in asthmatic and non-asthmatic subjects.
FIGURE 2
FIGURE 2
Multiple logistic regression models (odds ratio) for infection (at least three infections) and antibiotic (any) use in relation to childhood otitis, childhood hospitalisation and childhood asthma in general population and asthmatic subjects. Adjusted for age, sex, smoking status, body mass index and centre.
FIGURE 3
FIGURE 3
Multiple logistic regression models (odds ratio) for infection (at least three infections) and antibiotic (any) use in relation to occupational and environmental exposure (in the past 12 months) in general population and asthmatic subjects. Adjusted for age, sex, smoking status, body mass index and centres. LMW: low molecular weight agents; HMW: high molecular weight agents.
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