Objective: To investigate the association between recurrent childhood and adolescent antibiotic exposure and the risk of adult-onset pneumonia in individuals aged 40 and over, using data from the United Kingdom Biobank (UKB). Methods: A total of 170 496 UKB participants without a history of pneumonia at baseline were included. Based on a baseline questionnaire, participants were categorized into an exposed group (recurrent early-life antibiotic use), a non-exposed group, or an unknown-exposure group. Cox proportional hazards regression models were applied to calculate HRs and their 95%CIs for pneumonia incidence, with the non-exposed group as the reference. Subgroup analyses were conducted to test for effect modification and heterogeneity, and the robustness of the findings was assessed through multiple sensitivity analyses. Results: During a median follow-up of 13.8 years, 6 041 incident pneumonia cases were recorded. After adjusting for major sociodemographic and lifestyle factors, a significantly increased risk of pneumonia was observed in both the exposed group (HR=1.42, 95%CI: 1.32-1.52) and the unknown-exposure group (HR=1.21, 95%CI: 1.11-1.31) compared with the non-exposed group. Subgroup analysis revealed that this association was stronger in individuals with baseline cancer but weaker in those with chronic obstructive pulmonary disease (COPD) (both P for interaction <0.05). The results remained robust across multiple sensitivity analyses, and the association varied with increasing age at pneumonia onset. Conclusions: Recurrent childhood and adolescent antibiotic exposure is associated with a significantly increased risk of adult-onset pneumonia in individuals aged 40 and older. Baseline health status, such as the presence of cancer or COPD, may act as an effect modifier for this association, and its strength appears to be influenced by age of onset. 目的： 基于英国生物银行（UKB）数据，探讨儿童期和青少年期反复抗生素暴露与≥40岁人群成年期肺炎发病风险之间的关联。 方法： 共纳入170 496名基线无肺炎史的UKB参与者。根据基线问卷调查结果，将参与者分为儿童期和青少年期反复抗生素暴露组、非暴露组和暴露未知组。采用Cox比例风险回归模型计算不同暴露分组与非暴露组相比的肺炎发病HR值及其95%CI。通过亚组分析检验效应异质性来评估潜在的交互作用，并通过多重敏感性分析评估结果的稳健性。 结果： 在中位随访13.8年期间，共发生新发肺炎6 041名。调整主要社会人口学和生活方式因素后，与无暴露组相比，暴露组与暴露未知组的肺炎发病风险均显著升高（HR=1.42，95%CI：1.32~1.52；HR=1.21，95%CI：1.11~1.31）。亚组分析提示，该关联在基线癌症患者中增强，而在慢性阻塞性肺疾病（COPD）患者中减弱（均交互作用P<0.05）。结果在多项敏感性分析中保持稳健，且发现该关联强度随发病年龄增长而变化。 结论： 儿童期和青少年期反复抗生素暴露会显著增加≥40岁人群成年期肺炎的发病风险。基线健康状况（如是否合并癌症或COPD）可能是该关联的效应修饰因素，且该风险关联的强度可能受发病年龄影响。.
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