A new study indicates that there is no overall association between antibiotic exposure and the development of inflammatory bowel disease (IBD); however, the use of metronidazole and quinolones during early childhood may be associated with a risk for subsequent Crohn's disease (CD).
Researchers conducted a case-control study of individuals registered in the UK Clinical Practice Research Datalink GOLD (CPRD GOLD). IBD cases were matched to controls (1:4) based on age, sex, general practice and the year of registration in the CPRD GOLD.
The findings showed no significant association between ever use of any antibiotic and ulcerative colitis (UC) (OR, 1.02; 95% CI, 0.72-1.44) or CD (OR, 1.01; 95% CI, 0.73-1.39) vs never use of antibiotics. There was a slight increase in the risk for CD among ever users of quinolones (OR, 1.76; 95% CI, 1.00-3.11) and metronidazole (OR, 1.43; 95% CI, 0.87-2.34) vs never users of any antibiotics. When the analysis was restricted to individuals registered in the CPRD GOLD before 3 months of age, antibiotic exposure was associated with an increased risk for CD (OR, 2.20; 95% CI, 0.75-6.43).
Writing in the journal Inflammatory Bowel Diseases, the authors said: "This is the first study to investigate the association in a long-term setting with access to prospectively collected prescription history at least 10 years before the diagnosis of IBD." They added that future research investigating this association should also consider potential reverse causality.