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. 2022 Nov 4;17(1):1760-1772.
doi: 10.1515/med-2022-0459. eCollection 2022.

Meta-analysis of early-life antibiotic use and allergic rhinitis

Xiang Liu  1 , Rongrong Wu  2 , Yong Fu  2 , Wenxin Chen  2 , Yang Chen  2 , Yangyan Yan  2 , Jing Bi  2 , Jia Liu  2
Affiliations

Meta-analysis of early-life antibiotic use and allergic rhinitis

Xiang Liu et al. Open Med (Wars). .

Abstract

This meta-analysis aimed to investigate the correlation between early-life antibiotic use and allergic rhinitis. PubMed, Embase, and the Cochrane Central Register of Controlled Trials databases were searched for available studies. Eighteen studies covering 1,768,874 children were included. Early-life antibiotics were associated with an increased incidence of allergic rhinitis (effect size (ES) = 5.00, 95% confidence interval [CI]: 4.88-5.13; I 2 = 95.7%, P heterogeneity <0.001). In Asia, Europe, and the USA, the incidence of allergic rhinitis in the antibiotic group was higher than that in the no medication group (Asia: ES = 3.68, 95% CI: 3.38-4.01; Europe: ES = 3.20, 95% CI: 3.00-3.42; USA: ES = 3.68, 95% CI: 2.74-4.95). Compared with the no medication group, children who received antibiotics in the first 1 week of life (ES = 5.75, 95% CI: 2.18-15.18), first 1 year of life (ES = 3.37, 95% CI: 3.20-3.55; I 2 = 64.2%, P heterogeneity = 0.001), or first 3 years of life (ES = 5.21, 95% CI: 2.42-11.19) had a higher incidence of allergic rhinitis. No individual study influenced the estimates of the meta-analysis. The funnel plot showed moderate symmetry and low publication bias. In conclusion, the use of antibiotics in early life was associated with allergic rhinitis. Still, most included studies analyzed antibiotic exposure as a dichotomous variable, without information on the type and dosage of antibiotics.

Keywords: allergic rhinitis; antibiotics; early life; meta-analysis.

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Conflict of interest statement

Conflict of interest: Authors state no conflict of interest.

Figures

Figure 1
Figure 1
Schematic representation of study identification, inclusion, and exclusion.
Figure 2
Figure 2
Forest plot for the incidence of allergic rhinitis in the antibiotic and no medication groups.
Figure 3
Figure 3
Forest plot for the subgroup analysis by study design in the antibiotic and no medication groups.
Figure 4
Figure 4
Forest plot for the subgroup analysis by area in the antibiotic and no medication groups.
Figure 5
Figure 5
Forest plot for the subgroup analysis by the timing of antibiotic exposure in the antibiotic and no medication groups.
Figure 6
Figure 6
Forest plot for the sensitivity analysis in the incidence of allergic rhinitis in the antibiotic and no medication groups.
Figure 7
Figure 7
Funnel plot for publication bias.
See this image and copyright information in PMC

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