54 Antibiotics but not Paracetamol Reduce the Risk for Recurrent Wheezing in Infants

BACKGROUND: Paracetamol (PCM) and antibiotic (ATB) use have been associated with risk for wheezing and asthma in children. The aim of this study was to verify the association of recurrent wheezing (≥3 episodes) in infancy and use of ATB or PCM in the first year of life. METHODS: Cross-sectional study using a standardized and validated questionnaire (EISL: Estudio Internacional sobre Sibilancias en Lactantes) with questions: Has your baby had wheezing or whistling in the chest area or bronchitis in the first 12 months of life? Has your baby had 3 or more wheezing episodes in the first year of life? How often has your baby used antibiotics in the first year of life? How often has your baby used paracetamol in the first year of life? Parents of infants, ages 12 to 15 months that attended to Health Centers for routine immunization were interviewed between September 2009 to September 2010 (EISL Phase III). Risk was demonstrated using Odds ratio and 95% CI. RESULTS: One thousand and 3 parents participated in the survey and 19.8% of infants had recurrent wheezing starting at 6.1 ± 3 months. The use of PCM was not related to the presence of recurrent wheezing [No PCM (OR = 0.91; 95% CI, 0.38-2.19; P = 0.83), PCM 1–3 times (OR = 1.21; 95% CI, 0.77-1.91; P = 0.4), PCM 4–6 times (OR = 1.21; 95% CI, 0.77-1.9; P = 0.41) and PCM ≥7 times (OR = 0.76; 95% CI, 0.51-1.13; P = 0.17)], while more frequent use of ATB reduced the risk of recurrent wheezing in the first year of life [No ATB (OR = 2.18; 95% CI, 1.35-3.51; P = 0.001), ATB 1–3 times (OR = 1.39; 95% CI, 0.93-2.07; P = 0.1), ATB 4–6 times (OR = 0.37; 95% CI, 0.22-0.62; P = 0.001) and PCM≥7 times (OR = 0.22; 95% CI, 0.07-0.66; P = 0.001)]. CONCLUSIONS: The frequent use of ATB reduced the risk of recurrent wheezing in the first year of life unlike PCM that was not associated with recurrent wheezing in this study population.