1. Dangerous liaisons
- Author
-
Ervin Ç. Mingomataj, Dominika Ambrożej, Milena Sokolowska, Marina Atanaskovic-Markovic, Matteo Bonini, Eva Untersmayr, Aspasia Karavelia, Christina Boccabella, Wojciech Feleszko, Liam O’ Mahony, Alessandra Arcolaci, Gerdien A. Tramper-Stranders, University of Zurich, Tramper‐Stranders, Gerdien, and Pediatrics
- Subjects
medicine.medical_specialty ,Allergy ,medicine.drug_class ,Antibiotics ,Immunology ,610 Medicine & health ,Microbial dysbiosis ,Dermatitis, Atopic ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,10183 Swiss Institute of Allergy and Asthma Research ,Pregnancy ,medicine ,Hypersensitivity ,Immunology and Allergy ,Humans ,Intensive care medicine ,Child ,030304 developmental biology ,Asthma ,0303 health sciences ,2403 Immunology ,Bacteria ,business.industry ,Infant ,Atopic dermatitis ,Antimicrobial ,medicine.disease ,3. Good health ,Anti-Bacterial Agents ,030228 respiratory system ,Child, Preschool ,2723 Immunology and Allergy ,Female ,business - Abstract
Microbiota composition and associated metabolic activities are essential for the education and development of a healthy immune system. Microbial dysbiosis, caused by risk factors such as diet, birth mode, or early infant antimicrobial therapy, is associated with the inception of allergic diseases. In turn, allergic diseases increase the risk for irrational use of antimicrobial therapy. Microbial therapies, such as probiotics, have been studied in the prevention and treatment of allergic diseases, but evidence remains limited due to studies with high heterogeneity, strain-dependent effectiveness, and variable outcome measures. In this review, we sketch the relation of microbiota with allergic diseases, the overuse and rationale for the use of antimicrobial agents in allergic diseases, and current knowledge concerning the use of bacterial products in allergic diseases. We urgently recommend 1) limiting antibiotic therapy in pregnancy and early childhood as a method contributing to the reduction of the allergy epidemic in children and 2) restricting antibiotic therapy in exacerbations and chronic treatment of allergic diseases, mainly concerning asthma and atopic dermatitis. Future research should be aimed at antibiotic stewardship implementation strategies and biomarker-guided therapy, discerning those patients that might benefit from antibiotic therapy.
- Published
- 2021