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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2024; 14(01): 017-019
DOI: 10.1055/s-0044-1788549
Journal Summary

Journal Summary: Do Antibiotics Predispose to the Development of Inflammatory Bowel Disease?

Authors

  • Parna Pathak 

    1   Kasturba Medical College (KMC) Manipal, Manipal, Karnataka, India

  • Arup Choudhury 

    2   Department of Medicine, Nagaon Medical College, Nagaon, Assam, India

Funding None.
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Brief Overview of the Study

Imbalances in the gut microbiota, also known as dysbiosis, can be caused by external factors such as antibiotics, leading to a decrease in the diversity of gut flora. Such imbalances can predispose individuals to inflammatory bowel disease (IBD), and this association has been reported in current pediatric literature. Research has shown that the use of antibiotics during childhood, and even during the peripartum period, can lead to the development of IBD in the future.[1] [2]

There is, however, a limited data available on the relation between antibiotic use and the risk of developing IBD in adults. To address this, a population-based cohort study was conducted by Faye et al. They utilized data from Danish nationwide registries and followed up on over 6 million individuals aged 10 years and above for a period of 18 years (2000–2018). The study was aimed to assess the impact of the dose–response relationship, timing, and class of antibiotics on the risk of developing IBD.[3] Since the study was done with the help of the Danish Civil Registration System, which carefully maintains patient data and prescriptions list, the risk of recall and selection bias and loss to follow-up were eliminated. The study found that antibiotic exposure was associated with an increased risk of IBD for all age groups, with the incidence risk ratio (IRR) being greatest among individuals aged 40 to 60 and ≥ 60 years (age 10–40 years, IRR 1.28, 95% confidence interval [CI] 1.25–1.32; age 40–60 years, IRR 1.48, 95% CI 1.43–1.54; age ≥ 60 years, IRR 1.47, 95% CI 1.42–1.53). For all age groups a positive dose–response was observed for both ulcerative colitis (UC) and Crohn's disease (CD). The study also found that the highest risk of developing IBD was observed 1 to 2 years after exposure to antibiotics, the risk increasing with number of courses (IRRs per antibiotic course were 1.11 [95% CI 1.10–1.12], 1.15 [95% CI 1.14–1.16], and 1.14 [95% CI 1.13–1.15] for individuals aged 10–40, 40–60, and ≥ 60 years). Most cases were reported after the use of antibiotic classes that are commonly prescribed to treat gastrointestinal (GI) pathogens, such as nitroimidazoles or fluoroquinolones. However, some cases were reported after the use of other non-GI-related antibiotics, such as narrow-spectrum penicillin. Interestingly, there was no association between IBD and nitrofurantoin, which is used to treat urinary tract infections and does not extensively affect the GI tract. This finding supports the hypothesis that dysbiosis in the gut can lead to IBD.

Ethical Statement

None.


Authors' Contributions

P.P. wrote the initial draft, performed the search, and reviewed the literature. A.C. reviewed the manuscript critically. Both approved the manuscript.


Data Availability Statements

There is no data associated with this work.




Publication History

Received: 14 May 2024

Accepted: 03 June 2024

Article published online:
29 July 2024

© 2024. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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