Antibiotic prescriptions in the first year of life increases the risk of pediatric inflammatory bowel disease: a population-based analysis
(3 May 2010: VIDYYA MEDICAL NEWS SERVICE) -- By comparing cases of pediatric IBD and antibiotic use, researchers from the University of Manitoba have discovered that infants who are prescribed antibiotics in the first year of life may be three times more likely to develop lifelong IBD than children not exposed to antibiotics.
Researchers believe that antibiotic use in infants can cause irrevocable impact to developing bowel flora, or bacteria, in the human bowel. Changes or irregularities in bowel flora are thought to be a potential cause of IBD. Bowel flora is established and remains relatively unchanged after one year of age. Taking antibiotics can temporarily change bowel flora, but after, use flora revert back.
Using the University of Manitoba IBD Epidemiological Database (UMIBDED), a database of all Manitobans diagnosed with IBD, researchers identified all children (age 11 and younger) diagnosed with IBD between 1996 and 2008 and cross referenced these records with the Drug Program Information Network, a database of all prescriptions. They compared the prescription records of the children with IBD to a matched cohort database of children without IBD. The control cohort of 360 children was matched to the 36 children diagnosed with IBD on the basis of age, gender and region of residence during diagnosis. Sixty percent of the children with IBD had received one or more prescription antibiotic in the first year of life compared with 39 percent of the control group.
"Our findings suggest that antibiotic use in the first year of life is associated with developing IBD in childhood. It is also possible that children who require antibiotics may for other reasons be predisposed to developing IBD. However, if the use of antibiotics is associated with triggering IBD, it may be by impacting upon bowel flora at a vulnerable point in development," said Charles Bernstein, MD, professor of medicine, head of the section of gastroenterology and director of the University of Manitoba IBD Clinical and Research Center.
He added, "This association may give us cause to think about the overuse of antibiotics in young children, especially those who may be at risk for developing IBD, such as children with siblings who have IBD." Bernstein noted that antibiotic use should not be eliminated in newborns, but should be prescribed more vigilantly.
To confirm this study's findings, more research with another population and larger sample sizes is necessary.
Souradet Y. Shaw, MD, will present these data on Sunday, May 2 at 10:30 a.m. CT in 295-296, Ernest N. Morial Convention Center.
Digestive Disease Week® 2010 (DDW®) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases, the AGA Institute, the American Society for Gastrointestinal Endoscopy and the Society for Surgery of the Alimentary Tract, DDW takes place May 1 – May 5, 2010 in New Orleans, LA. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.
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