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Frequent antibiotics use may increase the risk of developing inflammatory bowel disease for adults over 40, according to research published in the journal Gut. The study suggests that people taking antibiotics for intestinal infections are at higher risk, with the highest risk one to two years post-use.
There is growing evidence that environmental factors are likely involved in the development of intestinal inflammatory disease (IBD). Nearly 7 million people worldwide suffer from this disease, and it is expected to increase in the next decade, according to the researchers.
One factor associated with IBD risk in young people is the use of antibiotics. It is not certain that this association also applies to seniors.
To delve deeper into this issue, researchers drew on national medical data from 2000 to 2018 for Danish citizens aged 10 years and older who had not received a diagnosis of IBD. They wanted to know precisely if the timing and dose of antibiotics could be important for the development of ibd and if it varied depending on the ibd and the type of antibiotic. In particular, they wanted to know if the timing and dose of antibiotics could be important for the development of IBDs and if this varied depending on IBDs and the type of antibiotic.
The study involved more than 6.1 million people, a little more than half of them women. In total, 5.5 million (91%) antibiotics have been prescribed at least once from 2000-2018, 36,017 new cases of ulcerative colitis and 16,881 new cases of Crohn's disease have been identified. Overall, compared to the absence of antibiotic use, the use of these medications was associated with a higher risk of developing IBD at any age. But aging had the highest risk associated with it.
10 to 40 years old were 28% more likely to receive a diagnosis of IBD; People aged 40 to 60 were 48 percent more likely to do so, while people over 60 were 47 percent more likely to do so. The risk for Crohn's disease was slightly higher than for ulcerative colitis: 40% in the 10-40 age group, 62% in the 40-60 age group and 51% in the 60-plus age group. The risk for Crohn's disease was slightly higher than for ulcerative colitis: 40% in the 10-40 age group, 62% in the 40-60 age group and 51% in the over-60 age group.
The risk appeared cumulative as each subsequent course added 11%, 15% and 14% more, depending on the age group. The highest risk was found in children aged 10 to 40 who were prescribed five or more antibiotics, or 69%; doubling the risk in people aged 40-60; And an increased risk of 95 percent for people over the age of 60, The greatest risk of IBD is one to two years after exposure to antibiotics, each year thereafter with a reduced risk. Timing also appeared to have an influence, with the highest risk of IBD occurring one to two years after exposure to antibiotics, with each subsequent year associated with reduced risk.
Specifically, for those 10 to 40 years of age, the risk of IBD was 40% higher one to two years after antibiotic use, compared to 13% four to five years later. The corresponding figures for the 40-60 age group were 66% against 21% and for those over 60, 63% against 22%.
With respect to the type of antibiotic, the greatest risk of IBD was associated with nitroimidazoles and fluoroquinolones, which are typically used to treat intestinal infections. They are called wide-spectrum antibiotics because they target all microbes indiscriminately, not only those who cause the disease.nitrofurantoin was the only type of antibiotic not associated with risk ibd at all ages. Narrow-spectrum penicillins have also been associated with ibd, though much less so.
Nitrofurantoin was the only type of antibiotic unrelated to the risk of IBD at any age. It is a study of observation, and as such, cannot establish the cause.
It is a study of observation, and as such, cannot establish the cause.
Neither did the researchers have information on the use of the drugs nor on the number of patients they were taking.
However, there are plausible biological explanations for these discoveries, they suggest, Highlighting the natural decline in resilience and microbial range in the intestinal microbiome associated with aging, There is a risk that antibiotic use will increase.
'In addition, with repeated antibiotic treatments, these changes may become more pronounced, eventually limiting the recovery of the intestinal microbiota,' they add.Restricting antibiotic prescriptions can not only help stop antibiotic resistance, but can also help reduce the risk of IBD, they say.
Reference: “Antibiotic use as a risk factor for inflammatory bowel disease across the ages: a population-based cohort study” by Adam S Faye, Kristine Hojgaard Allin, Aske T Iversen, Manasi Agrawal, Jeremiah Faith, Jean-Frederic Colombel and Tine Jess, 9 January 2023, Gut.
DOI: 10.1136/gutjnl-2022-327845
