Association of Repeated Exposure to Antibiotics With the Development of Pediatric Crohn's Disease-A Nationwide, Register-based Finnish Case-Control Study
Association of Repeated Exposure to Antibiotics With the Development of Pediatric Crohn's Disease-A Nationwide, Register-based Finnish Case-Control Study
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DOI：
10.1093/aje/kwr400
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发表时间：
2012-04-15
影响因子：
5
通讯作者：
Kolho, Kaija-Leena
中科院分区：
文献类型：
--
作者：
Virta, Lauri;Auvinen, Anssi;Kolho, Kaija-Leena
为了确定儿童时期接触抗生素是否与患炎症性肠病(IBD)的风险有关，作者进行了一项基于登记的全国性研究，涵盖了芬兰1994-2008年出生并在2010年10月被诊断为炎症性肠病的所有儿童。作者确定了595名IBD儿童(233名克罗恩病和362名溃疡性结肠炎)和2380名年龄、性别和居住地匹配的对照组儿童。从出生到索引日期，儿童克罗恩病的风险随着购买抗生素的次数增加，并在排除诊断前6个月的情况下持续存在(7-10次购买与没有购买，优势比=3.48，95%可信区间：1.57，7.34；条件Logistic回归)。在男孩中，克罗恩病与抗生素的使用之间的关联比女孩更强(P=0.01)。头孢菌素类药物与克罗恩病的相关性最强(购买3次与不使用相比，优势比=2.82，95%可信区间：1.65，4.81)。抗生素暴露与儿童溃疡性结肠炎的发生无关。反复使用抗生素可能反映了儿童感染和儿童克罗恩病的共同易感性，或者也可能引发疾病的发展。
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.