In a new study, researchers found antibiotics use, particularly antibiotics with a greater spectrum of microbial coverage, may be associated with an increased risk of new-onset inflammatory bowel disease (IBD) and its subtypes ulcerative colitis and Crohn’s disease.
This is the largest study so far linking antibiotic therapy and the risk of IBD.
The research was conducted by a team at Karolinska Institutet in Sweden and Harvard Medical School in the United States.
IBD is becoming more common, particularly in Europe, the U.S. and other parts of the world undergoing rapid economic development, increased sanitation, and more frequent use of antibiotics.
With a growing appreciation for the gut microbiome’s role in maintaining human health, concern has risen that antibiotics may perturb and permanently alter these fragile microbial communities.
This could potentially impact the risk of gastrointestinal disease.
In the study, the researchers were able to demonstrate that more frequent use of antibiotics was associated with the development of IBD and its subtypes, ulcerative colitis and Crohn’s disease.
They identified almost 24,000 new IBD cases (16,000 had ulcerative colitis and 8,000 Crohn’s disease) and compared them with 28,000 siblings, and 117,000 controls from the general population.
Prior use of antibiotics (never vs. ever) was linked to a nearly two-times increased risk of IBD after adjusting for several risk factors.
The increased risk was noted for both ulcerative colitis and Crohn’s disease with the highest estimates corresponding to broad-spectrum antibiotics.
According to the researchers, earlier studies in the field have been small, and few have had a follow-up beyond a few years.
In contrast, the researchers in this study were able to enroll all consecutive, eligible patients with new-onset IBD from a population-based register over a ten-year study period, limiting selection bias.
IBD affects nearly 1% of the Swedish population and can have a substantial effect on patients’ life. It has been linked to an increased risk of both death and cancer.
One author of the study is Dr. Long Nguyen at Massachusetts General Hospital and Harvard Medical School, Boston, U.S.
The study is published in The Lancet Gastroenterology & Hepatology.
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