Association between Early-Life Antibiotic Exposure and Recurrent Wheezing in Children Under Five: A Hospital-Based Cross-Sectional Study in the Agrarian Setting of Adesh Medical College, Haryana
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Abstract
Background
The prevalence of recurrent wheezing in preschool children is a growing public health concern in developing nations. The "gut-lung axis" hypothesis suggests that early-life antibiotic exposure (ELAE) induces intestinal dysbiosis, which may impair immune maturation and predispose infants to respiratory morbidity. In the agrarian belt of Kurukshetra, Haryana, this biological vulnerability is potentially exacerbated by environmental factors such as crop residue burning and biomass fuel use.
Objectives
To estimate the association between antibiotic exposure during the first 12 months of life and recurrent wheezing in children aged 12–60 months. Secondary objectives included analyzing antibiotic prescription patterns based on World Health Organization (WHO) indicators and assessing the impact of local environmental risk factors like stubble burning and indoor biomass fuel use.
Methodology
A hospital-based cross-sectional study was conducted at Adesh Medical College and Hospital (AMCH), Mohri, Shahabad, from February 2023 to November 2023. A systematic random sample of 400 children aged 1 to 5 years was selected from the Pediatric Department. Data were collected using a validated questionnaire adapted from the International Study of Asthma and Allergies in Childhood (ISAAC) Phase III. Antibiotic history was verified through medical records. Multivariate logistic regression was used to calculate Adjusted Odds Ratios (aOR).
Results
The prevalence of recurrent wheezing was 18.5%. Antibiotic use in the first year of life was significantly associated with recurrent wheezing (aOR: 2.18; 95% CI: 1.12–4.25; p=0.02). Children receiving >3 courses of antibiotics faced a higher risk. Environmental analysis revealed that 70.2% of wheezers resided in areas with high exposure to agricultural smoke or used biomass fuel. Prescription analysis indicated a high reliance on third-generation cephalosporins (45%) for respiratory complaints.
Conclusion
Early-life antibiotic exposure acts as a significant, modifiable risk factor for recurrent wheezing in this rural population. The findings support the need for strict antimicrobial stewardship and public health interventions to mitigate environmental air pollution in Haryana.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Dr. Tarun Bharatkumar Ghorecha
Assistant Professor, Department of Paediatrics, Adesh Medical College and Hospital, Mohri, Shahbad, Haryana
Dr. Shivendra Varshney
Assistant Professor, Department of Paediatrics, Adesh Medical College and Hospital, Mohri, Shahbad, Haryana
Mr. Alok Pritam
Statistician Cum Tutor, Department of Community Medicine, Lord Buddha Koshi Medical College and Hospital, Saharsa, Bihar, India
