Inflammatory Bowel Disease Clinical and Research Centre, University of Manitoba, Manitoba, Canada.
Am J Gastroenterol. 2010 Dec;105(12):2687-92. doi: 10.1038/ajg.2010.398. Epub 2010 Oct 12.
The development of commensal flora in infants has been shown to be sensitive to antibiotic use. Altered intestinal flora is thought to contribute to the etiology of inflammatory bowel disease (IBD), an idiopathic chronic condition. We aimed to determine if early use of antibiotics was associated with the development of IBD in childhood.
Nested case-control analysis of the population-based University of Manitoba Inflammatory Bowel Disease Epidemiologic Database was carried out. IBD status was determined from a validated administrative database definition. A total of 36 subjects diagnosed between 1996 and 2008 were matched to 360 controls, on the basis of age, sex, and geographic region. Antibiotic data were drawn from the Manitoba Drug Program Information Network, a comprehensive population-based database of all prescription drugs for all Manitobans dating back to 1995. Antibiotic use in the first year of life was compared between IBD cases and controls.
The mean age at IBD diagnosis was 8.4 years. Twenty-one cases (58%) had one or more antibiotic dispensations in their first year of life compared with 39% of controls. Crohn's disease was diagnosed in 75% of IBD cases. Those receiving one or more dispensations of antibiotics were at 2.9 times the odds (95% confidence interval: 1.2, 7.0) of being an IBD case.
Subjects diagnosed with IBD in childhood are more likely to have used antibiotics in their first year of life.
婴儿共生菌群的发育对抗生素的使用很敏感。肠道菌群的改变被认为是炎症性肠病（IBD）的病因之一，IBD 是一种特发性慢性疾病。我们旨在确定早期使用抗生素是否与儿童时期 IBD 的发展有关。
对基于人群的曼尼托巴大学炎症性肠病流行病学数据库进行了嵌套病例对照分析。IBD 状态是根据经过验证的行政数据库定义确定的。总共 36 名在 1996 年至 2008 年间诊断出的患者与 360 名对照者进行了匹配，匹配的依据是年龄、性别和地理区域。抗生素数据取自曼尼托巴药物计划信息网络，这是一个针对所有曼尼托巴人的综合基于人群的所有处方药数据库，可以追溯到 1995 年。比较了 IBD 病例和对照组在生命第一年的抗生素使用情况。
IBD 诊断的平均年龄为 8.4 岁。21 例（58%）在生命的第一年中有一次或多次抗生素配药，而对照组为 39%。IBD 病例中有 75%被诊断为克罗恩病。接受一次或多次抗生素配药的患者发生 IBD 的几率是对照组的 2.9 倍（95%置信区间：1.2，7.0）。
在儿童期被诊断出患有 IBD 的患者在生命的第一年更有可能使用抗生素。
