DDW: Antibiotics Up Risk of Older-Onset Inflammatory Bowel Disease

FRIDAY, May 13, 2022 (HealthDay News) -- Use of antibiotics, regardless of class, is associated with an increased risk of older-onset inflammatory bowel disease (IBD), according to a study presented at the 2022 Digestive Disease Week, held from May 21 to 24 in San Diego.

Adam S. Faye, M.D., from NYU Grossman School of Medicine in New York City, and colleagues assessed the impact of cumulative antibiotic use, the timing of antibiotic use, and the association between specific antibiotic classes and the development of older-onset IBD. Analysis included 2.3 million individuals (aged 60 to 90 years) followed from 2000 to 2018.

The researchers found that any antibiotic use was associated with an increased risk for developing IBD (incidence rate ratio [IRR], 1.64), with a positive dose response observed (one course of antibiotics: IRR, 1.27; two courses: IRR, 1.54; three courses: IRR, 1.66; four courses: IRR, 1.96; five or more courses: IRR, 2.35). All antibiotic classes were associated with the development of IBD, including those not used to treat gastrointestinal infections. Fluoroquinolones (IRR, 2.27), nitroimidazoles (IRR, 2.21), and macrolides (IRR, 1.74) had the highest risk. Generally, effect estimates were slightly higher for Crohn disease versus ulcerative colitis. Risk was highest in the first one to two years after antibiotics, but the risk remained elevated for five years.

"Antibiotic stewardship is important; but avoiding antibiotics at all costs is not the right answer either," Faye said in a statement. "If you're not sure what you are treating, I would be cautious. If patients are coming in with clear infections, and they need antibiotics, they should not be withheld because of these findings."

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