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Antibiotic Exposure Linked to Risk for Inflammatory Bowel Disease

Patients receiving one, two, three or more antibiotic dispensations have increased odds of IBD

THURSDAY, Aug. 20, 2020 (HealthDay News) — Higher cumulative exposure to antibiotics is associated with an increased risk for new-onset inflammatory bowel disease (IBD), according to a study published online Aug. 17 in The Lancet Gastroenterology & Hepatology.

Long H. Nguyen, M.D., from Massachusetts General Hospital in Boston, and colleagues identified 23,982 patients with IBD diagnosed between Jan. 1, 2007, and Dec. 31, 2016, as well as 117,827 matched controls and 28,732 siblings to examine the association between antibiotic therapy and IBD.

The researchers found that the adjusted odds ratio for patients who had used antibiotics versus those who had never used antibiotics was 1.88 for a diagnosis of incident IBD, 1.74 for ulcerative colitis, and 2.27 for Crohn disease after adjustment for several risk factors. Compared with patients who received no antibiotic dispensations, those who received one, two, and three or more antibiotic dispensations had higher adjusted odds ratios (1.11, 1.38, and 1.55, respectively). Increased risk was seen for ulcerative colitis and Crohn disease (adjusted odds ratios with three or more dispensations, 1.47 and 1.64, respectively); higher estimates corresponded with broad-spectrum antibiotics. When siblings were used as the reference group, the results were similar but attenuated, with an adjusted odds ratio of 1.35 for patients receiving three or more dispensations compared with general population controls.

“Further studies are needed to investigate how antibiotics might permanently alter gut microbial communities, potentially culminating in disease development,” the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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