scholarly journals Antibiotic use during pregnancy and childhood overweight: A population-based nationwide cohort study

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Tine Jess ◽  
Camilla S. Morgen ◽  
Maria C. Harpsøe ◽  
Thorkild I. A. Sørensen ◽  
Teresa A. Ajslev ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antibiotic Use ◽  
Childhood Overweight ◽  
Population Based

scholarly journals Primary Care Consultations after Hospitalisation for Pneumonia: A Large Population-based Cohort Study

2020 ◽  
pp. BJGP.2020.0890
Author(s):  
Vadsala Baskaran ◽  
Fiona Pearce ◽  
Rowan H Harwood ◽  
Tricia McKeever ◽  
Wei Shen Lim
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Large Population ◽  
Significant Proportion ◽  
Antibiotic Use ◽  
Population Based ◽  
Practice Research ◽  
Clinical Practice Research Datalink ◽  
Respiratory Disorder ◽  
The Impact

Background: Up to 70% of patients report ongoing symptoms four weeks after hospitalisation for pneumonia, and the impact on primary care is poorly understood. Aim: To investigate the frequency of primary care consultations after hospitalisation for pneumonia, and the reasons for consultation. Design: Population-based cohort study. Setting: UK primary care database of anonymised medical records (Clinical Practice Research Datalink, CPRD) linked to Hospital Episode Statistics (HES), England. Methods: Adults with the first ICD-10 code for pneumonia (J12-J18) recorded in HES between July 2002-June 2017 were included. Primary care consultation within 30 days of discharge was identified as the recording of any medical Read code (excluding administration-related codes) in CPRD. Competing-risks regression analyses were conducted to determine the predictors of consultation and antibiotic use at consultation; death and readmission were competing events. Reasons for consultation were examined. Results: Of 56,396 adults, 55.9% (n=31,542) consulted primary care within 30 days of discharge. The rate of consultation was highest within 7 days (4.7 per 100 person-days). The strongest predictor for consultation was a higher number of primary care consultations in the year prior to index admission (adjusted sHR 8.98, 95% CI 6.42-12.55). The commonest reason for consultation was for a respiratory disorder (40.7%, n=12,840), 12% for pneumonia specifically. At consultation, 31.1% (n=9,823) received further antibiotics. Penicillins (41.6%, n=5,753) and macrolides (21.9%, n=3,029) were the commonest antibiotics prescribed. Conclusion: Following hospitalisation for pneumonia, a significant proportion of patients consulted primary care within 30 days, highlighting the morbidity experienced by patients during recovery from pneumonia.

scholarly journals Maternal Antibiotic Use and Infections During Pregnancy and Offspring Asthma: The Norwegian Mother, Father and Child Cohort Study and a Nationwide Register Cohort

2021 ◽  
Author(s):  
Aino K. Rantala ◽  
German Tapia ◽  
Maria C Magnus ◽  
Lars Christian Stene ◽  
Jouni JK Jaakkola ◽  
...  
Keyword(s):  
Cohort Study ◽  
Antibiotic Use ◽  
Population Based ◽  
Prescription Database ◽  
Upper Respiratory Tract ◽  
Maternal Characteristics ◽  
Increased Risk ◽  
Norwegian Prescription Database ◽  
Tract Infections

Abstract Maternal antibiotic use during pregnancy has been linked to asthma risk in children, but the role of underlying infections remains unclear. We investigated the association of maternal antibiotic use and infections during pregnancy with offspring risk of asthma. We used two population-based cohorts: the Norwegian Mother, Father and Child Cohort Study (MoBa) (n=53 417) and a register cohort (n=417 548). Asthma was defined based on dispensed asthma medications at 7 and 13 years from the Norwegian Prescription Database. Self-reported information on antibiotic use and infections during pregnancy was available in MoBa, while registrations of dispensed prescriptions was used to classify use of antibiotics in the register-based cohort. Maternal antibiotic use during pregnancy was associated with asthma at 7 years in both cohorts (aRR 1.23, 95% CI 1.11 - 1.37 in MoBa and aRR 1.21, 95% CI 1.16 - 1.25 in the register-based cohort) and asthma at 13 years in the register cohort (aRR 1.13, 95% CI 1.03-1.23) after adjusting for maternal characteristics. In MoBa, the estimate was attenuated after adjusting for infections during pregnancy. Maternal lower and upper respiratory tract infections (aRR 1.30, 95% CI 1.07 - 1.57 and aRR 1.19, 95% CI 1.09 - 1.30, respectively) and urinary tract infections (aRR 1.26, 95% CI 1.11 - 1.42) showed associations with asthma at 7 after adjusting for confounders, but estimates decreased after adjustment for antibiotics during pregnancy. Our findings suggest that both maternal antibiotic use and infections during pregnancy might be associated with an increased risk of asthma in childhood.

Maternal antibiotic use during pregnancy and asthma in children: population-based cohort study and sibling design

2021 ◽  
Vol 57 (1) ◽  
pp. 2000937
Author(s):  
Natalie C. Momen ◽  
Xiaoqin Liu
Keyword(s):  
Cohort Study ◽  
Childhood Asthma ◽  
Cox Regression ◽  
Antibiotic Use ◽  
Epidemiological Studies ◽  
Population Based ◽  
Hospital Treatment ◽  
Familial Factors ◽  
Asthma Risk ◽  
Using Data

Antibiotic use during pregnancy may affect asthma risk in offspring. However, epidemiological studies yielded conflicting findings, with an observed association possibly confounded by shared familial factors. We sought to assess the association between maternal antibiotic use during pregnancy and childhood asthma in the offspring, by accounting for time-stable familial factors.We conducted a population-based cohort study and sibling study using data from Danish nationwide registers, which comprised 407 804 liveborn singletons from 2005 to 2011. Antibiotic use during pregnancy was defined as at least one antibiotic prescription filled by the mother from 1 month prior to pregnancy up until delivery, identified in the National Prescription Registry. First-time asthma in the offspring was determined by hospital treatment or asthma medication treatment after age 5 years. We estimated hazard ratios (HRs) of asthma using Cox regression in the population-based cohort and stratified Cox regression in the sibling cohort.Approximately 36.5% of pregnant women redeemed antibiotic prescriptions. Antibiotic use during pregnancy was associated with childhood asthma in cohort analyses (HR 1.21, 95% CI 1.18–1.24), but not in sibling analyses (HR 0.96, 95% CI 0.90–1.03). In the population-based analyses, higher risks of asthma were seen with longer duration of maternal antibiotic use, a higher number of prescriptions and prescriptions of multiple types of antibiotics. All these associations disappeared in the sibling analyses.The associations observed by previous studies for prenatal exposure to antibiotics and offspring asthma risk are likely to be due to confounding factors shared within families.

scholarly journals Antibiotic use in children with asthma: cohort study in UK and Dutch primary care databases

BMJ Open ◽  
2018 ◽  
Vol 8 (11) ◽  
pp. e022979 ◽  
Author(s):  
Esmé J Baan ◽  
Hettie M Janssens ◽  
Tine Kerckaert ◽  
Patrick J E Bindels ◽  
Johan C de Jongste ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Antibiotic Use ◽  
Population Based ◽  
Health Improvement ◽  
Antibiotic Overuse ◽  
Asthmatic Children ◽  
Antibiotic Drugs ◽  
Children With Asthma ◽  
Tract Infections

ObjectivesTo compare the rate, indications and type of antibiotic prescriptions in children with and without asthma.DesignA retrospective cohort study.SettingTwo population-based primary care databases: Integrated Primary Care Information database (IPCI; the Netherlands) and The Health Improvement Network (THIN; the UK).ParticipantsChildren aged 5–18 years were included from January 2000 to December 2014. A child was categorised as having asthma if there were ≥2 prescriptions of respiratory drugs in the year following a code for asthma. Children were labelled as non-asthmatic if no asthma code was recorded in the patient file.Main outcome measuresRate of antibiotic prescriptions, related indications and type of antibiotic drugs.ResultsThe cohorts in IPCI and THIN consisted of 946 143 and 7 241 271 person years (PY), respectively. In both cohorts, antibiotic use was significantly higher in asthmatic children (IPCI: 197vs126 users/1000 PY, THIN: 374vs250 users/1000 PY). In children with asthma, part of antibiotic prescriptions were for an asthma exacerbation only (IPCI: 14%, THIN: 4%) and prescriptions were more often due to lower respiratory tract infections then in non-asthmatic children (IPCI: 18%vs13%, THIN: 21%vs12%). Drug type and quality indicators depended more on age, gender and database than on asthma status.ConclusionsUse of antibiotics was higher in asthmatic children compared with non-asthmatic children. This was mostly due to diseases for which antibiotics are normally not indicated according to guidelines. Further awareness among physicians and patients is needed to minimise antibiotic overuse and limit antibiotic resistance.

scholarly journals Association of oral ciprofloxacin, levofloxacin, ofloxacin and moxifloxacin with the risk of serious ventricular arrhythmia: a nationwide cohort study in Korea

BMJ Open ◽  
2018 ◽  
Vol 8 (9) ◽  
pp. e020974 ◽  
Author(s):  
Yongil Cho ◽  
Hyun Soo Park
Keyword(s):  
Cohort Study ◽  
Ventricular Arrhythmia ◽  
Primary Outcome ◽  
Tertiary Care ◽  
Antibiotic Use ◽  
Population Based ◽  
Administrative Claims ◽  
Increased Risk ◽  
Oral Ciprofloxacin ◽  
Reduced Risk

ObjectiveTo evaluate whether oral ciprofloxacin, levofloxacin, ofloxacin and moxifloxacin increase the risk of ventricular arrhythmia in Korea’s general population.DesignPopulation-based cohort study using administrative claims data on a national scale in Korea.SettingAll primary, secondary and tertiary care settings from 1 January 2015 to 31 December 2015.ParticipantsPatients who were prescribed the relevant study medications at outpatient visits.Primary outcome measuresEach patient group that was prescribed ciprofloxacin, levofloxacin, ofloxacin or moxifloxacin was compared with the group that was prescribed cefixime to assess the risk of serious ventricular arrhythmia (ventricular tachycardia, fibrillation, flutter and cardiac arrest). Using logistic regression analysis with inverse probability of treatment weighting using the propensity score, OR and 95% CI for serious ventricular arrhythmia were calculated for days 1–7 and 8–14 after the patients commenced antibiotic use.ResultsDuring the study period, 4 888 890 patients were prescribed the study medications. They included 1 466 133 ciprofloxacin users, 1 141 961 levofloxacin users, 1 830 786 ofloxacin users, 47 080 moxifloxacin users and 402 930 cefixime users. Between 1 and 7 days after index date, there was no evidence of increased serious ventricular arrhythmia related to the prescription of ciprofloxacin (OR 0.72; 95% CI 0.49 to 1.06) and levofloxacin (OR 0.92; 95% CI 0.66 to 1.29). Ofloxacin had a 59% reduced risk of serious ventricular arrhythmia compared with cefixime during 1–7 days after prescription. Whereas the OR of serious ventricular arrhythmia after the prescription of moxifloxacin was 1.87 (95% CI 1.15 to 3.11) compared with cefixime during 1–7 days after prescription.ConclusionsDuring 1–7 days after prescription, ciprofloxacin and levofloxacin were not associated with increased risk and ofloxacin showed reduced risk of serious ventricular arrhythmia. Moxifloxacin increased the risk of serious ventricular arrhythmia.

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