NEW YORK (Reuters Health) - Antibiotic use is associated with the subsequent development of Crohn’s disease, according to results of a case-control study the UK. Whether antibiotics are the cause of the disorder, however, remains unknown.
Genetic factors are recognized as playing a role in Crohn’s disease, but other elements must be involved to account for the rise in incidence over the last century, Dr. Tim Card, at the University of Nottingham, UK, and colleagues explain in the February issue of Gut.
Since intestinal flora is associated with Crohn’s disease, Dr. Card’s group surmised that antibiotics, by interfering with normal colonization, may be one of the missing components in disease etiology. They therefore analyzed data from the General Practice Research Database, where antibiotic use had been prospectively recorded.
They identified 587 patients with Crohn’s disease for whom data had been recorded for at least 5 years prior to diagnosis, with whom the authors matched 1460 control subjects by age and gender.
Antibiotics were prescribed at least once 2 to 5 years before the index date for 71% of cases and 58% of controls (p < 0.001). In multivariate analysis excluding subjects with symptoms suggestive of Crohn’s disease and those prescribed a gastrointestinal drug 2 to 5 years before the index date, the odds ratio was 1.53. This, according to Dr. Card’s team, “is evidence against the association being a result of reverse causation.
The authors estimate that the population attributable fraction was 17% for antibiotics, versus 10% for smoking, another recognized risk factor for Crohn’s disease.
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Previous studies looking at the link between antibiotic use and the disease were based on recall of the use of antibiotics in children, assessed many years after the diagnosis of Crohn’s disease was made, the British group points out. They believe that their study is the first to investigate the association in adults using prospectively gathered data.
Source: Gut 2004;53:246-250. [ Google search on this article ]
MeSH Headings:Biological Sciences: Biology: Genetics: Linkage (Genetics): Biological SciencesCopyright © 2002 Reuters Limited. All rights reserved. Republication or redistribution of Reuters content, including by framing or similar means, is expressly prohibited without the prior written consent of Reuters. Reuters shall not be liable for any errors or delays in the content, or for any actions taken in reliance thereon. Reuters and the Reuters sphere logo are registered trademarks and trademarks of the Reuters group of companies around the world.
