Dangerous liaisons: Bacteria, antimicrobial therapies, and allergic diseases. Issue 11 (27th August 2021)

• Record Type: Journal Article
• Authors: Tramper‐Stranders, Gerdien; Ambrożej, Dominika; Arcolaci, Alessandra; Atanaskovic‐Markovic, Marina; Boccabella, Cristina; Bonini, Matteo; Karavelia, Aspasia; Mingomataj, Ervin; O' Mahony, Liam; Sokolowska, Milena; Untersmayr, Eva; Feleszko, Wojciech
• Is Part Of: Allergy. Volume 76:Issue 11(2021)
• Page Start: 3276
• Page End: 3291
• Publication Date: 2021-08-27
• Subjects: allergy -- antibiotics -- bacterial lysates -- microbiota -- probiotics; Allergy -- Periodicals; 616.97
• DOI: 10.1111/all.15046
• Languages: English
• ISSNs: 0105-4538

Abstract

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. Abstract :