Broad-spectrum antibiotic exposure ups risk of IBD

Exposure to broad-spectrum antibiotics may put individuals at risk of developing inflammatory bowel disease (IBD), such that the greater the dose, the higher the risk, as shown in a study.

For the study, researchers performed a population-based case–control analysis using data from the Korean National Health Insurance Service database (2004–2018). The analysis included 68,633 patients with new-onset IBD (mean age at diagnosis was 45.2 years) and 343,165 matched non-IBD controls.

Multivariable conditional logistic regression models showed that antibiotic prescriptions between 2 and 5 years before diagnosis was significantly associated with increased odds of developing IBD (adjusted odds ratio [OR], 1.24, 95 percent confidence interval [CI], 1.21–1.27). Of note, sensitivity analysis showed that the risk increase persisted for up to 9 years before diagnosis.

The researchers noted that broad-spectrum antibiotics contributed to an increase in IBD risk, independent of gastroenteritis. Furthermore, the association followed a distinct dose–response fashion irrespective of the IBD subtype and study population (all p<0.001).

Finally, in a separate analysis of childhood-onset IBD (age ≤14 years) risk following early-life antibiotic use, antibiotic exposure within the first year of life showed a significant association with childhood-onset IBD risk (OR, 1.51, 95 percent CI, 1.25–1.82).

The present data provide a fundamental epidemiological basis for establishing antibiotic use as a significant risk factor for IBD across different environmental backgrounds.