TY - JOUR
T1 - Patterns of antibiotic exposure and clinical disease activity in inflammatory bowel disease
T2 - A 4-year prospective study
AU - Hashash, Jana G.
AU - Chintamaneni, Preethi
AU - Ramos Rivers, Claudia M.
AU - Koutroubakis, Ioannis E.
AU - Regueiro, Miguel D.
AU - Baidoo, Leonard
AU - Swoger, Jason M.
AU - Barrie, Arthur
AU - Schwartz, Marc
AU - Dunn, Michael A.
AU - Binion, David G.
N1 - Publisher Copyright:
© 2015 Crohn's & Colitis Foundation of America, Inc.
PY - 2015/7/25
Y1 - 2015/7/25
N2 - Background: Antimicrobial treatment is known to cause short- and long-term changes in the composition of normal human microbiota. The relationship between antibiotic use and overall clinical behavior in inflammatory bowel disease (IBD) has not been explored. We aim to prospectively characterize patterns of antibiotic use and clinical IBD activity in a large IBD cohort. Methods: Prospective observational study from a longitudinal IBD natural history registry between 2009 and 2012. Antibiotic prescriptions were identified and categorized using electronic medical record data. Cumulative rates over the 4-year study period were compared. Demographic, clinical, laboratory, health care utilization, and treatment data of the patients with IBD were collected and analyzed. Quality of life was measured by Short IBD Questionnaire data. Primary outcomes were markers of disease activity including Short IBD Questionnaire scores, C-reactive protein levels, health care utilization, and medication use. Results: Seven hundred eighteen patients followed over 4 years were included (47.6% male; mean age, 46.7 ± 15.2 yr), 59.9% had Crohn's disease, whereas 38.6% had ulcerative colitis. Most patients (66.3%) were exposed to antibiotics during the study period. Antibiotic-exposed patients were more likely to have Crohn's disease (63% versus 53.7%; P 0.05), require narcotics (43.7% versus 14.9%; P < 0.0001), receive antidepressants (43.1% versus 18.6%; P < 0.001), prednisone (52.7% versus 31%; P < 0.0001), or biological therapy (52% versus 36.5%; P < 0.0001). Antibiotic-exposed patients had a lower mean Short IBD Questionnaire (50.2 ± 11.5 versus 56.4 ± 9.5; P < 0.0001), higher rates of C-reactive protein elevation (49.2% versus 31.8%; P < 0.0001), and higher health care utilization compared with nonantibiotic-exposed patients. Conclusions: The majority of patients with IBD receive antibiotic treatment, and these individuals demonstrate a more severe clinical course.
AB - Background: Antimicrobial treatment is known to cause short- and long-term changes in the composition of normal human microbiota. The relationship between antibiotic use and overall clinical behavior in inflammatory bowel disease (IBD) has not been explored. We aim to prospectively characterize patterns of antibiotic use and clinical IBD activity in a large IBD cohort. Methods: Prospective observational study from a longitudinal IBD natural history registry between 2009 and 2012. Antibiotic prescriptions were identified and categorized using electronic medical record data. Cumulative rates over the 4-year study period were compared. Demographic, clinical, laboratory, health care utilization, and treatment data of the patients with IBD were collected and analyzed. Quality of life was measured by Short IBD Questionnaire data. Primary outcomes were markers of disease activity including Short IBD Questionnaire scores, C-reactive protein levels, health care utilization, and medication use. Results: Seven hundred eighteen patients followed over 4 years were included (47.6% male; mean age, 46.7 ± 15.2 yr), 59.9% had Crohn's disease, whereas 38.6% had ulcerative colitis. Most patients (66.3%) were exposed to antibiotics during the study period. Antibiotic-exposed patients were more likely to have Crohn's disease (63% versus 53.7%; P 0.05), require narcotics (43.7% versus 14.9%; P < 0.0001), receive antidepressants (43.1% versus 18.6%; P < 0.001), prednisone (52.7% versus 31%; P < 0.0001), or biological therapy (52% versus 36.5%; P < 0.0001). Antibiotic-exposed patients had a lower mean Short IBD Questionnaire (50.2 ± 11.5 versus 56.4 ± 9.5; P < 0.0001), higher rates of C-reactive protein elevation (49.2% versus 31.8%; P < 0.0001), and higher health care utilization compared with nonantibiotic-exposed patients. Conclusions: The majority of patients with IBD receive antibiotic treatment, and these individuals demonstrate a more severe clinical course.
KW - IBD
KW - antibiotics
KW - disease activity
KW - quality of life
UR - http://www.scopus.com/inward/record.url?scp=84945254686&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84945254686&partnerID=8YFLogxK
U2 - 10.1097/MIB.0000000000000534
DO - 10.1097/MIB.0000000000000534
M3 - Article
C2 - 26296061
AN - SCOPUS:84945254686
SN - 1078-0998
VL - 21
SP - 2576
EP - 2582
JO - Inflammatory bowel diseases
JF - Inflammatory bowel diseases
IS - 11
ER -