Optimising treatment in children with early-life infections and asthma

This thesis shows in the first part with discordant twin analyses that antibiotic use at early age (0-2 years) is associated with asthma later in childhood despite adjustment for genetic and environmental factors, but not with attention-deficit hyperactivity disorder and autism spectrum disorder. Therefore, caregivers should outweigh the risks and benefits of early-life antibiotic use before prescribing antibiotics at early age.
In the second part of this thesis it was studied whether genetic variants could explain why part of the children with asthma experience exacerbations despite asthma medication use. First, a systematic review of pharmacogenetics of long-acting beta2 agonists is described. In the following chapters, three new single nucleotide polymorphisms were identified that possibly contribute to the increased odds of exacerbations despite asthma medication use. These results contribute to personalise asthma medication based on the genetic profile of children with asthma and merit further investigation for use in clinical practice.