Hviid A, Svanström H, Frisch M. Gut 2011;60:49–54.
These investigators conducted a nationwide observational cohort study to examine the potential association between the use of antibiotics and IBD in childhood. They found a strong association between antibiotic use and pediatric IBD.
The intestinal microflora has been considered an important component in the inflammatory processes in IBD; antibiotics can alter its composition by reducing resistance to colonization with opportunistic microorganisms. This Danish group conducted a cohort study that included all singleton children born in Denmark between 1995 and 2003 to analyze the association between the use of antibiotics and IBD. By consulting the Danish Drug Prescription Registry, it was possible to obtain information about individual-level prescriptions. Antibiotics were classified as penicillin V, extended-spectrum penicillins, macrolides, and other systemic antibiotics, and their use was quantified as “courses”. Incidence rate ratios (RRs) of IBD were calculated according to antibiotic use.