This content is available to ASGE Members only. If you are member, please login to access the content. If you are not a member, learn about joining ASGE

Antibiotic Use and the Subsequent Risk of Developing Inflammatory Bowel Disease

Francis A. Farraye, MD, MSc, FASGE reviewing Oh SJ, et al. Aliment Pharmacol Ther 2023 May 8.

Certain environmental variables, such as diet and smoking, have been proposed to be involved in the development of inflammatory bowel disease (IBD). Several studies have demonstrated that early childhood exposure to antibiotics is associated with the subsequent development of IBD, presumably due to alteration in the microbiome. There is less known about the effects of antibiotics on the development of IBD in adults.

Using data obtained from the Korean National Health Insurance Service from 2004 to 2018, the authors conducted a population-based case-control study utilizing multivariable conditional logistic regression analysis to compare 68,633 patients with new-onset IBD and 343,165 matched controls. The mean age at diagnosis was 45.2 ± 16.8 years. Antibiotic prescriptions 2 to 5 years before diagnosis significantly increased the odds of developing IBD by approximately 24% (adjusted odds ratio [OR], 1.24; 95% confidence interval [CI], 1.21-1.27). The authors observed a dose-response relationship regardless of the IBD subtype (all P<.001). Finally, broad-spectrum antibiotics, rather than narrow-spectrum, increased the risk for IBD.


Accumulating evidence supports the association between antibiotic use and the development of IBD in both pediatric and adult patient populations. These data also suggest antibiotic use may be contributing to rising rates of IBD in newly industrialized non-Western countries. Prudent use of antibiotics is appropriate for all individuals, particularly individuals at increased risk, such as first-degree relatives of patients with IBD.

Francis A. Farraye, MD, MSc, FASGE

Bio and Disclosures


Oh SJ, Kim HJ, Lee CK; Big Data Research Group (BDRG) of the Korean Society of Gastroenterology. A dose-dependent increase in the risk of inflammatory bowel disease after exposure to broad-spectrum antibiotics: a national population study in Korea. Aliment Pharmacol Ther 2023 May 8. (Epub ahead of print) (