Correlation between antibiotic use in childhood and subsequent inflammatory bowel disease: a systematic review and meta-analysis

Abstract

Background: Antibiotic use leads to a cascade of inflammatory reaction in the gastrointestinal tract due to its association with a temporary disruption of human microbiome.

Objectives: To explore the undetermined correlation between antibiotic use in childhood and subsequent inflammatory bowel disease (IBD).

Methods: PUBMED, EMBASE and Cochrane Central Register of Controlled Trials were searched to identify related articles. We extracted and pooled the (adjusted) odds ratio (OR) and (adjusted) risk ratio (RR).

Results: This systematic review and meta-analysis included 11 studies. The pooled OR of all 11 studies was 1.5 (95% confidence interval (CI): 1.22–1.85). The pooled ORs of the subsequent Crohn’s disease and ulcerative colitis after antibiotic use in childhood were 1.59 (95% CI: 1.06–2.4) and 1.22 (95% CI: 0.82–1.8). The sensitivity analysis showed no change. The meta-regression showed there was not statistical significance for the publication year, research area and research methods. Egger’s test showed publication bias in the IBD studies (p  =  .006  <  .05) but no publication bias for the CD (p  =  .275>.05) and UC studies (p  =  .537>.05).

Conclusions: There was a positive association between antibiotic use in childhood and the subsequently risk of Crohn’s disease in non-European countries in the west during 2010–2013. Children in the United States taking antibiotics will have a higher risk of subsequently IBD than Europe, Asia and Australia.

Registration number: CRD42019147648 (PROSPERO)

Keywords:

• Ulcerative colitis
• Crohn’s disease
• inflammatory bowel disease
• antibiotics
• childhood
• meta-analysis

Author contributions

W. Xu, X. Zhou, K. Ye equally contributed to this paper. Y. Zou, searched the relevant literature, analyzed the data and wrote the manuscript. Y. Zou and Y. Xie designed the research. Y. Zou, L. Wu, W. Xu, X. Zhou, K. Ye and H. Xiong performed the research. Y. Xie and C. Song designed the study and edited the manuscript as the corresponding author. The authors had full access to the data and take full responsibility for the integrity of the data. All the authors gave their approval for the submission of the final manuscript for the submission of the final manuscript.

Disclosure statement

The authors declare no conflict of interest related to this study.

Additional information

Funding

This study was supported by the National Natural Science Foundation of China [No. 81760105], the Natural Science Foundation of Jiangxi Province [20142BAB205073], the Science and Technology Projects of Jiangxi Province [No. 20161BBG70113], the Research training platform of Nanchang University [No. 3598], National Natural Science Foundation of China (No. 81260076) and Leading Talent Training Plan of the Gan-Po Outstanding Talents 555 Project of Jiangxi Province (2010-3-61).