Any use of antibiotics appears to increase the risk of inflammatory bowel disease, but antibiotics used for intestinal infection are the most effective. A research team, by analyzing more than 6.1 million people in Denmark, found that the risk was greatest one to two years after use. 5.5 million (91 percent) were prescribed at least one course of antibiotics between 2000 and 2018. During the same period, 36,017 people were diagnosed with ulcerative colitis and 16,881 had Crohn’s disease.

Taking antibiotics was associated with a higher risk of developing these conditions: people ages 10 to 40 were 28 percent more likely to develop IBD, people ages 40 to 60 were 48 percent more likely, and those who Those over 60 are 47 percent more likely.

The risk of developing Crohn’s disease from antibiotics was slightly higher than from ulcerative colitis. The risk increased when more antibiotics were taken: Each dose of antibiotic increased the risk by an additional 11, 15 or 14 percent, depending on the age group. People who were prescribed five or more courses of antibiotics were twice as likely to develop IBD.

This is observed most frequently with nitroimidazoles and fluoroquinolones. These are broad spectrum antibiotics that are used, among other things, to treat intestinal infections. They target many different bacteria and not just specific pathogens. Inflammatory bowel disease has also been reported with narrow-spectrum penicillin use, but to a much lesser extent. This supports the hypothesis that changes in the gut microbiota could play a major role in the development of IBD. The research team sees these findings as further evidence that antibiotics should be used cautiously and as specifically as possible.

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Which: DOI 10.1136/gotgnl-2022-327845

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