A greater risk of older-onset IBD (inflammatory bowel disease) was found in antibiotics that target gastrointestinal infections. This was confirmed by a population-based study conducted in Denmark.
In the analysis of over 2 million adults ages 60 and over, use of any antibiotic was associated with a 64% higher risk for developing IBD (incidence rate ratio [IRR] 1. 64, 95% CI 1.58-1. 71), reported Adam Faye, MD, of the NYU Grossman School of Medicine in New York City.
The highest risk was observed in the first to second year following an antibiotic prescription (IRR 1). 87, 95% CI 1.79-1. 94), however, the risk persisted at 2-5 years (IRR 1. 42, 95% CI 1.36-1. 48), according to his presentation at a press briefing ahead of the Digestive Disease Week meeting, held virtually and in San Diego this year.
“Inflammatory stool disease is often overlooked by older adults due to the many diagnoses that are available,” stated Faye. It is important to consider this, especially if a patient has reported that they have received multiple courses of antibiotics in the last few years. “
IBD risk increased from 27% after a single course of antibiotics in the past 5 years (IRR 1. 27, 95% CI 1.21-1. 33) to 135% with five or more courses (IRR 2. 35, 95% CI 2.24-2. 47), the study found.
Older patients are the fastest growing subpopulation of IBD, accounting for 15% of new cases, Faye said during his presentation, but this subset is less likely to have a family history of either ulcerative colitis or Crohn’s disease, raising the possibility of other factors playing a greater role.
The study found that the association was limited to antibiotics that target pathogens within the gastrointestinal tract. The highest risk was seen with fluoroquinolones, (IRR 2.). 27, 95% CI 2.08-2. 48), nitroimidazoles (IRR 2. 21, 95% CI 1.95-2. 50), and macrolides (IRR 1. 74, 95% CI 1.64-1.84).
“This stresses in our clinical practice the need to be judicious in the use of antibiotics, including [to] limit inappropriate use and overprescribing,” said Sandra El-Hachem, MD, of the Allegheny Center for Digestive Health in Pittsburgh, who was not involved in this stud