The composition of the intestinal microflora has been proposed as an important factor in the development of inflammatory bowel diseases (IBD).
Antibiotics have the potential to alter the composition of the intestinal microflora.
Dr Anders Hviid and colleagues from Denmark performed a study to evaluate the potential association between use of antibiotics and IBD in childhood.
The research team undertook a nationwide cohort study of 577,627 Danish singleton children born from 1995 to 2003 with individual-level information on filled antibiotic prescriptions, IBD and potential confounding variables.
Using Poisson regression, rate ratios of IBD were calculated according to antibiotic use.
|The rate ratio of IBD was 1.8 for antibiotic users vs non-users |
Antibiotic use was classified according to time since use, type, number of courses used and age at use.
IBD was diagnosed in 117 children during 3,173,117 person-years of follow-up.
The team found that the rate ratio of IBD was 1.8 for antibiotic users compared with non-users.
This association appeared to have an effect on Crohn's disease alone, and was strongest in the first 3 months following use.
Among children with 7 courses of antibiotics or more, the rate ratio was 7.3.
Dr Hviid's team comments, "Antibiotic use is common in childhood and its potential as an environmental risk factor for IBD warrants scrutiny."
"This is the first prospective study to show a strong association between antibiotic use and Crohn's disease in childhood."
"However, as with any observational study, causality cannot be inferred from our results and confounding by indication, in particular, prescribing of antibiotics to children with intestinal symptoms of as yet undiagnosed Crohn's disease, should also be considered as a possible explanation."