Antibiotic use a risk factor for inflammatory bowel disease in elderly

The more antibiotics prescribed to patients 60 and older, the more likely they were to develop inflammatory bowel disease, suggesting antibiotic use could explain some of the growth in Crohn's disease and ulcerative colitis in older people.  

The researchers from this recent study reviewed prescribing records for people aged 60 and older who were newly diagnosed with inflammatory bowel disease. The study looked at the number of courses of antibiotics prescribed, how recently they had been prescribed in relation to the diagnosis and specific classes of antibiotics used.

The study found that any antibiotic use was associated with higher rates of inflammatory bowel disease, and the risk went up substantially with each course. After one prescription, patients were 27 percent more likely than those with no antibiotic use to be diagnosed with inflammatory bowel disease. With two courses, the risk rose by 55 percent and with three courses it rose by 67 percent. With four courses, risk rose by 96 percent; and with five or more, seniors were more than 2.3 times, or 236 percent, more likely to receive a new inflammatory bowel disease diagnosis than those with no antibiotics in the previous five years.

The relationship was found for all types of antibiotics, except nitrofurantoin, which is commonly prescribed for urinary tract infections. Hence, it was concluded that antibiotics usually prescribed for gastrointestinal infections were the most likely to be associated with a new inflammatory bowel disease diagnosis. Therefore, inflammatory bowel disease, which can easily be overlooked in this age group, should be considered, especially when there's a history of antibiotic prescriptions.