ReviewEuropean journal of clinical pharmacology2013
The case of drug causation of childhood asthma: antibiotics and paracetamol.
Review in European journal of clinical pharmacology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 56 citations in OpenAlex.
- A systematic review of associations between environmental exposures and development of asthma in children aged up to 9 years.BMJ open · 2014Pooled it
- A Single Early-Life Acetaminophen Exposure Causes Persistent Abnormalities in the Murine Lung.American journal of respiratory cell and molecular biology · 2025Article
- Antibiotics, Analgesic Sedatives, and Antiseizure Medications Frequently Used in Critically Ill Neonates: A Narrative Review.Children (Basel, Switzerland) · 2024Review
- Racing against time: leveraging preclinical models to understand pulmonary susceptibility to perinatal acetaminophen exposures.American journal of physiology. Lung cellular and molecular physiology · 2022Review
- Acetaminophen and the Developing Lung: Could There Be Lifelong Consequences?The Journal of pediatrics · 2021Review
- Early life microbial exposures and allergy risks: opportunities for prevention.Nature reviews. Immunology · 2021Review
- First 1000 Days of Life: Consequences of Antibiotics on Gut Microbiota.Frontiers in microbiology · 2021Review
- E-Synthesis: A Bayesian Framework for Causal Assessment in Pharmacosurveillance.Frontiers in pharmacology · 2019Article
- Long-term adverse effects of paracetamol - a review.British journal of clinical pharmacology · 2018Review
- Can the Use of Antibiotics Alter the Susceptibility to Allergic Diseases?Allergy, asthma & immunology research · 2018Article
- Article
- Effects of Acetaminophen on Oxidant and Irritant Respiratory Tract Responses to Environmental Tobacco Smoke in Female Mice.Environmental health perspectives · 2016Article
- Adverse consequences of neonatal antibiotic exposure.Current opinion in pediatrics · 2016Review
- Prevalence, Severity, and Treatment of Recurrent Wheezing During the First Year of Life: A Cross-Sectional Study of 12,405 Latin American Infants.Allergy, asthma & immunology research · 2016Article
- Antibiotic stewardship: reassessment of guidelines for management of neonatal sepsis.Clinics in perinatology · 2015Review
- Relationship between prenatal antibiotic use and asthma in at-risk children.Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology · 2015Article
- The role of the early-life environment in the development of allergic disease.Immunology and allergy clinics of North America · 2015Review
- Article
- Antibiotics in fetal and early life and subsequent childhood asthma: nationwide population based study with sibling analysis.BMJ (Clinical research ed.) · 2014Article
- Microbiome diversity and asthma and allergy risk.Current allergy and asthma reports · 2014Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimThe rising prevalence of bronchial asthma has led to world-wide efforts to understand and stem this development. Cross-sectional studies appear to show that early childhood use of antibiotics may be an important contributory factor, with paracetamol as an additional suspected cause. However, mounting evidence, which is reviewed here, points to various confounding factors as the major reasons for these reported associations.
methodsPubMed and EMBASE were systematically searched for studies on associations between antibiotics and/or paracetamol with asthma and/or wheezing, published up to November 2012. A total of 64 pertinent studies were identified, 35 focusing on antibiotics, 19 on paracetamol, and ten addressing both antibiotics and paracetamol, bringing the number of relevant datasets to 74.
resultsNumerous studies were cross-sectional and made no adjustment for the indication of antibiotics or paracetamol; consequently, they were unable to dismiss possible confounding by indication. Where such adjustments could be performed (mostly in longitudinal studies), they substantially weakened or entirely eliminated the association with asthma or asthma surrogates present in the unadjusted data.
conclusionThe weight of evidence of the collected studies in our review strongly suggests that the association of antibiotics with childhood asthma reflects various forms of bias, the most prominent of which is confounding by indication. Recent studies and meta-analyses support the same conclusion for paracetamol. Truly indicated antibiotics should not be withheld from infants or young children for fears they might develop asthma. Likewise, there is no sound reason to replace paracetamol as the preferred pain relief and fever medication in this age group.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.