Antibiotic Use and the Subsequent Risk of Developing Inflammatory Bowel Disease

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.