Antibiotic overuse and allergy-related diseases: an epidemiological cross-sectional study in the grasslands of Northern China

BACKGROUND: Several studies have shown that the use of antibiotics early in life significantly increases the risk of asthma in children. It is unclear whether antibiotics are more commonly used in patients with allergy-related diseases. METHODS: A multistage, clustered and random sampling with a field-interviewer-administrated survey study was performed to investigate if there was multiple use of antibiotics (MUA) in patients with allergic rhinitis (AR), conjunctivitis, chronic urticaria (CU), and asthma in the grasslands of northern China. MUA was defined as antibiotic usage for at least 3 days and for more than 3 times a year in the past 2 years. RESULTS: A total of 5,787 subjects completed the study, with 1,079 subjects (18.6%) identified as MUA. MUA was more common in patients with AR (23.7% vs 16.2%, P<0.001), conjunctivitis (22.5% vs 17.1%, P<0.001), asthma (31.8% vs 17.7%, P<0.001), and CU (25.9% vs 18.3%, P<0.01) than in subjects without allergic diseases. There is an increasing percentage of MUA in patients with a single, two, and three or more diseases both in children (20.1%, 25.0%, and 31.4%, respectively, P=0.014) and in adults (19.1%, 23.4%, and 32.9%, respectively, P<0.001). MUA is significantly associated with AR (OR=1.7, 95% CI: 1.3–2.1, P<0.001), conjunctivitis (OR=1.6, 95% CI: 1.2–2.1, P=0.001), asthma (OR=2.3, 95% CI:1.6–3.3, P<0.001) and CU (OR=2.1, 95% CI: 1.2–3.6, P=0.006) in children aged 2–17 years; and in adults (≥18 years old) for AR (OR=1.7, 95% CI: 1.4–2.1, P<0.001), conjunctivitis (OR=1.3, 95% CI:1.1–1.6, P=0.002), and asthma (OR=2.0, 95% CI: 1.5–2.7, P<0.001). CONCLUSION: Antibiotic overuse might be associated with increased risk of allergy-related disease. It is important that implementation of the evidence-based international guidelines for the management of allergy-related diseases needs to be improved, in order to avoid unnecessary use of antibiotics.