Antibiotics and asthma: How much is too much?

This is an image of a young, Black boy receiving an oral medicine via a syringe.

We know that too much of a good thing can have the opposite effect. Antibiotic resistance, for example, is a modern-day problem that makes it harder to fight bacterial infections. Now, a new study suggests that too many antibiotics in childhood could lead to the development of asthma later in life.

Researchers at Monash University in Clayton, Victoria, Australia, detailed the findings of their study, “Antibiotic-Driven Dysbiosis in Early Life Disrupts Indole-3-Propionic Acid Production and Exacerbates Allergic Airway Inflammation in Adulthood.” The study, which was published in Immunity, explains how repeated antibiotic use among pediatric patients can cause short-term disruption of healthy gut bacteria, potentially leading to asthma in adults. The good news, however, is that consuming a dietary supplement of indole-3-propionic acid (IPA) may reverse the effects.

This is a professional headshot of the lead researcher in the story, Benjamin Marsland, PhD.Benjamin Marsland, PhD“We know that recurrent use of antibiotics early in life disrupts a person’s healthy gut microbiota and increases the risk of allergies and asthma,” said lead researcher Benjamin Marsland, PhD, a professor of immunology and pathology at Monash University. “We have discovered that a consequence of antibiotic treatment is the depletion of bacteria that produce IPA, thus reducing a key molecule that has the potential to prevent asthma.” 

According to Dr. Marsland, the first years of life are important in developing a stable gut microbiota via “food intake — both milk and solid foods — as well as genetics and environmental exposures.”

“Infants at high risk of allergies and asthma have been shown to have a disrupted and delayed maturation of the gut microbiome,” Dr. Marsland said.

Infants and toddlers are often prescribed antibiotics for bacterial infections. Repeated antibiotic use in a short span can reduce a person’s IPA during those early years of critical lung maturation.

Researchers studied mice that were predisposed to asthma. When given antibiotics early, researchers found the mice were more susceptible to house dust mite (HDM)-induced allergic airway inflammation and this lasted into adulthood. Asthma is commonly triggered by exposure to HDM.

This susceptibility was maintained long-term as well, even after the gut microbiome and IPA levels returned to normal, highlighting the importance of the discovery. When the mice were given an IPA supplement early in life, researchers found that the mice were cured of developing the HDM-induced allergic airway inflammation, or asthma, in adulthood.

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