TY - JOUR
T1 - Dangerous liaisons
T2 - Bacteria, antimicrobial therapies, and allergic diseases
AU - Tramper-Stranders, Gerdien
AU - Ambrożej, Dominika
AU - the EAACI Task Force on Conscious and Rational use of Antibiotics in Allergic Diseases
AU - Arcolaci, Alessandra
AU - Atanaskovic-Markovic, Marina
AU - Boccabella, Cristina
AU - Bonini, Matteo
AU - Karavelia, Aspasia
AU - Mingomataj, Ervin
AU - O' Mahony, Liam
AU - Sokolowska, Milena
AU - Untersmayr, Eva
AU - Feleszko, Wojciech
N1 - Funding Information:
Outside the budget from the EAACI for the task force, no funds were granted to this project We want to thank Zuzana Lukasik for the creative work.
Publisher Copyright:
© 2021 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd.
PY - 2021/11
Y1 - 2021/11
N2 - 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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=85113666820&partnerID=8YFLogxK
U2 - 10.1111/all.15046
DO - 10.1111/all.15046
M3 - Article
C2 - 34390006
AN - SCOPUS:85113666820
SN - 0105-4538
VL - 76
SP - 3276
EP - 3291
JO - Allergy: European Journal of Allergy and Clinical Immunology
JF - Allergy: European Journal of Allergy and Clinical Immunology
IS - 11
ER -