PHO Rounds: Preventing Childhood Asthma: The Neglected Impacts of Antibiotic Stewardship and Human

Asthma is the most prevalent chronic disease of childhood in high-income countries. The epidemic grew rapidly in the late 20th century but there are now signs of declining incidence and prevalence in several countries. Early infancy is a key period for immune system development under the influence of genetics, host biology and environment, including the developing gut microbiota. A recent meta-analysis concludes a roughly doubled risk of asthma for children who receive antibiotics in infancy and other studies show that, breast feeding was found to substantially mitigate antibiotic-associated disruption of microbiota and asthma risk. This session of PHO Rounds presents a recently concluded study of 600,000 Canadian children in two provinces, showing that this association is operating in populations at a scale that may help to explain observed tempering of the asthma epidemic. We will address important critiques of this hypothesis and conclude with a discussion of next steps for research and possible implications for clinical and public health practice. By the end of this session, participants will be able to: • Describe recent changes in childhood asthma epidemiology, including possible explanations and correlation with changing antibiotic use in infancy • Recognize current evidence linking perturbation of the developing infant gut microbiota and subsequent experience of atopic disease • Summarize studies to date and describe published findings from the Canadian Healthy Infant Longitudinal Development Study and a cohort study of 600,000 Canadian children from BC and Manitoba • Discuss current implications, knowledge gaps and future research in the field of childhood asthma Presenter(s): Dr. David Patrick The presentation can be found here: https://www.publichealthontario.ca/en...