Intestinal microbial flora participate in the pathogenesis of inflammatory bowel disease.
Because antibiotic therapy alters intestinal microbial flora, Dr Aberra and colleagues from Pennsylvania hypothesized that use of antibiotics might decrease the risk of flare.
The researchers conducted a case-crossover study by using the General Practice Research Database from 1989 to 1997.
The investigators identified flares of disease by receipt of a new prescription for either corticosteroids or mesalamine medications after an interval of at least 4 months without prescriptions for either class of medication.
The primary exposure was receipt of any antibiotics in the 60 days preceding the index date.
|A protective effect was observed in those patients with exposure within 15 days|
|Clinical Gastroenterology and Hepatology|
The researchers found that among 1205 patients with Crohn’s disease, exposure to antibiotics was associated with a reduced risk of flare.
The team noted that the effect was strongest with more recent exposure.
The researchers observed that among 2230 patients with ulcerative colitis, use of any antibiotics within 60 days was not associated with flare of disease.
A potentially protective effect was observed in those patients with very recent exposure of 15 days.
Dr Aberra’s team concluded, “Antibiotic use within 60 days was associated with a lower risk of flare of Crohn’s disease, but not ulcerative colitis.”
“The strength of the protective effect of antibiotics in Crohn’s disease wanes over time."