Children’s Hospital, University of Helsinki, Box 281, FIN-00029 Helsinki, Finland.
Am J Epidemiol. 2012 Apr 15;175(8):775-84. doi: 10.1093/aje/kwr400. Epub 2012 Feb 24.
To determine whether childhood exposure to antibiotics is associated with the risk of developing inflammatory bowel disease (IBD), the authors conducted a national, register-based study comprising all children born in 1994-2008 in Finland and diagnosed with IBD by October 2010. The authors identified 595 children with IBD (233 with Crohn's disease and 362 with ulcerative colitis) and 2,380 controls matched for age, gender, and place of residence. The risk of pediatric Crohn's disease increased with the number of antibiotic purchases from birth to the index date and persisted when the 6 months preceding the case's diagnosis were excluded (for 7-10 purchases vs. none, odds ratio = 3.48, 95% confidence interval: 1.57, 7.34; conditional logistic regression). The association between Crohn's disease and antibiotic use was stronger in boys than in girls (P = 0.01). Cephalosporins showed the strongest association with Crohn's disease (for 3 purchases vs. nonuse, odds ratio = 2.82, 95% confidence interval: 1.65, 4.81). Antibiotic exposure was not associated with the development of pediatric ulcerative colitis. Repeated use of antibiotics may reflect shared susceptibility to childhood infections and pediatric Crohn's disease or alternatively may trigger disease development.
为了确定儿童时期接触抗生素是否与炎症性肠病（IBD）的发病风险相关，作者开展了一项全国性的基于登记的研究，该研究纳入了芬兰所有 1994 年至 2008 年间出生且于 2010 年 10 月前被诊断为 IBD 的儿童。作者共确定了 595 名 IBD 患儿（233 名克罗恩病患儿和 362 名溃疡性结肠炎患儿）和 2380 名年龄、性别和居住地相匹配的对照儿童。从出生到索引日期，抗生素购买次数与儿科克罗恩病的风险呈正相关，且当排除病例诊断前 6 个月的抗生素使用情况后，这种相关性仍然存在（与无抗生素使用相比，购买 7-10 次抗生素的比值比=3.48，95%置信区间：1.57，7.34；条件 logistic 回归）。抗生素使用与克罗恩病的相关性在男孩中强于女孩（P=0.01）。头孢菌素与克罗恩病的相关性最强（与未使用相比，使用 3 次的比值比=2.82，95%置信区间：1.65，4.81）。抗生素暴露与儿科溃疡性结肠炎的发生无关。抗生素的重复使用可能反映了儿童时期感染和儿科克罗恩病的共同易感性，或者可能会引发疾病的发展。
