New data from Danish researchers suggests that children who have many common infections early in life are at higher risk of moderate to severe infections and antibiotic use throughout their childhood.
The findings come from a study published today in Open JAMA Network, which analyzed data on common infection episodes and antibiotic prescriptions in a cohort of Danish children from birth to 10 or 13 years of age. Researchers at the University of Copenhagen found that children with high or low infection rates between birth and age 3 were more likely to have moderate to severe infections and to receive antibiotic treatment between 10 and 13 years old.
The researchers say the findings are useful for prognosis and monitoring of young children who have a high infection burden.
High or low infection burden
Using data from the Danish population-based Copenhagen Prospective Studies of Childhood Asthma (COPSAC) birth cohort, researchers analyzed daily symptom and medication diaries completed by parents of children aged 0-3 years, supported by scheduled and acute visits to COPSAC. clinical. Infections of interest included the common cold, gastroenteritis, episodes of fever, acute otitis media (earache), tonsillitis, and pneumonia.
The researchers then looked at data on diagnoses and prescriptions during clinic visits scheduled through February 2024, when the children were 10 or 13 years old. The incidence of moderate to severe infections and systemic antibiotics after age 3 years was estimated using adjusted incidence rate ratios (AIRR). The analysis was adjusted for social and environmental confounding factors, including gender, social circumstances, mode of delivery, maternal age, education, and income.
Of the 700 children included in the study, 614 had daily daily data on infections, from birth to 3 years. Among these children, there was an average of 16.4 infections, with the common cold being the most common infection identified. After the age of 3, the 614 children presented 268 moderate to severe infections, mainly pneumonia (77.6%), with an average of 2.32 antibiotic treatments per child.
This longitudinal cohort study suggests that the burden of early life infections may continue throughout childhood and is associated with later antibiotic treatment, independent of social and environmental risk factors.
When researchers compared children who had 16 or more infections before age 3 (high burden) with those who had 15 or fewer (low burden), they found a risk more than twice as high. moderate to severe infection after age 3. in the high-burden group (181 vs. 87 episodes; AIRR, 2.39; 95% confidence interval (CI), 1.52 to 3.89) and increased risk of systemic antibiotic treatments (799 vs. 632 episodes; AIRR, 1.34; 95% CI, 1.07 to 1.68).
The analysis also found that, even among children who were not in the high-burden group, each infection listed in the diary increased the subsequent risk of moderate to severe infections (AIRR, 1.05; 95% CI , 1.02 to 1.08) and systemic antibiotic treatments (AIRR, 1.02; 95% CI, 1.01-1.04). Subtype analyzes showed significant associations between each cold, acute otitis media, pneumonia, gastroenteritis and fever episode between birth and 3 years of age and an increased risk of subsequent moderate to severe infections or systemic antibiotic treatments .
Early infection burden and subsequent risks
“This longitudinal cohort study suggests that the burden of infections early in life may persist throughout childhood and is associated with later antibiotic treatments, independent of social and environmental risk factors,” the authors wrote. the study.
The authors also note that in addition to their findings, other studies have established links between the burden of infections in young children and the development of asthma, allergies, cardiometabolic risk factors, and more mental disorders. late in life.
“It is important for all pediatricians to discuss with families these disease trajectories associated with infections early in life, knowing that a high infection burden during the first years of life can increase the risk of more infections. late in childhood and a series of other chronic disorders later in life,” they wrote.
