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  • Jefferson Adams
    Jefferson Adams

    Antibiotics Put Children at Risk for Inflammatory Bowel Disease

    Reviewed and edited by a celiac disease expert.

    Caption: Photo: CC--Eye/See

    Celiac.com 11/28/2012 - A team of researchers recently set out to determine whether childhood antianaerobic antibiotic exposure is associated with the development of inflammatory bowel disease (IBD). Their findings show that children who are treated with antianaerobic antibiotics face a significantly higher risk of developing IBD.

    The team included Matthew P. Kronman, MD, MSCE, Theoklis E. Zaoutis, MD, MSCE, Kevin Haynes, PharmD, MSCE, Rui Feng, PhD, and Susan E. Coffin, MD, MPH.They are affiliated variously with the Division of Infectious Diseases, Seattle Children’s Hospital at the University of Washington in Seattle, Washington, the Division of Infectious Diseases at The Children’s Hospital of Philadelphia, and the Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics at the Perelman School of Medicine at the University of Pennsylvania in Philadelphia, Pennsylvania. The team's findings appear in the 24 September issue of Pediatrics.

    To get a better picture regarding use of antibiotics on children and a possible connection to IBD, the team conducted a retrospective cohort study using data from 464 UK ambulatory practices in The Health Improvement Network.

    The study looked at all children in the network with 2 or more years of follow-up from 1994 to 2009. The team screened and excluded anyone with previous IBD. They then cataloged all antibiotic prescriptions used by all children in the study. Finally, they tracked the children's data from practice enrollment and IBD development, practice de-registration, 19 years of age, or death.

    Their defined study parameters included the following antianaerobic antibiotics: penicillin, amoxicillin, ampicillin, penicillin/β-lactamase inhibitor combinations, tetracyclines, clindamycin, metronidazole, cefoxitin, carbapenems, and oral vancomycin.

    Their study looked at 1,072,426 children for a total of 6.6 million person-years of follow-up. Of those children, 748 developed IBD. Children treated with antianaerobic antibiotics had nearly 1.52 cases of IBD per ten-thousand person years, while those who were not given antibiotics saw just 0.83 cases per ten-thousand person-years; for an 84% relative risk differential.

    Antibiotic exposure throughout childhood was associated with the development of IBD, but this relationship decreased with increasing age at exposure. That is, the longer doctors waited to give children antibiotics, the more the risk of iBD went down.

    Children treated with antibiotics before 1 year of age showed an adjusted hazard ratio of 5.51 (95% confidence interval [CI]: 1.66–18.28), while that decreased to 2.62 (95% CI: 1.61–4.25) for children first treated at 5 years old, and to 1.57 (95% CI: 1.35–1.84) for those first treated at 15 years of age. Overall, each course of antibiotics increased the IBD hazard by 6% (4%–8%).

    The study showed that children who received two or more antibiotic courses were more highly likely to develop IBD than those who received 1 to 2 courses, with adjusted hazard ratios of 4.77 (95% CI: 2.13–10.68) versus 3.33 (95% CI: 1.69–6.58).

    So, based on this study, treating children with antianaerobic antibiotics puts them at risk for developing IBD. It will be interesting to see how the medical community responds to this study, and whether there is greater effort made to avoid giving these powerful antibiotics to children.

    What do you think? Do you have IBD? Did you receive these antibiotics as a kid? Let us know your thoughts by commenting below.

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    There are many natural alternatives to using prescription antibiotics. I wish I had known about them before damaging my children with antibiotics needlessly. My oldest daughter still has stomach problems 2 years after being on 2 different antibiotics in 2 weeks time. I've never used them since, but use herbs, minerals, wholesome food, and probiotics.

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    I took antibiotics many, many times as a child and adult (up until just a few years ago, and I'm in my mid 50s). I also developed celiac disease (severe, but undiagnosed for the first half of my life). I strongly believe that these two facts are related. Antibiotics were given out like candy when I grew up--for every cold and flu, which I had every month or two as a child (poor immunity). I have many health issues now, and I believe antibiotics were a huge part of their development (food allergies, autoimmune issues, etc.) I do not recommend them now, unless there is a life threatening issue--they are "anti-life."

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    I'm 51 now. I took Bicillin prophylacticly for a number of years as a young child to prevent/reduce incidence of bronchitis, an after effect of complicated measles aged 3 (pneumonia), which I suppose was treated with antibiotics. I also had quite bad asthma, hayfever and allergies, which I have thankfully 'grown out of.' I had a total colectomy for refractory ulcerative colitis after years of ill health 10 years ago. In hind sight, I probably had UC as a teenager, but not diagnosed until 30.

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  • About Me

    Jefferson Adams is Celiac.com's senior writer and Digital Content Director. He earned his B.A. and M.F.A. at Arizona State University, and has authored more than 2,000 articles on celiac disease. His coursework includes studies in science, scientific methodology, biology, anatomy, medicine, logic, and advanced research. He previously served as SF Health News Examiner for Examiner.com, and devised health and medical content for Sharecare.com. Jefferson has spoken about celiac disease to the media, including an appearance on the KQED radio show Forum, and is the editor of the book "Cereal Killers" by Scott Adams and Ron Hoggan, Ed.D.

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