Table 3.
Spectrum of antibiotic coverage and inflammatory bowel disease comparing cases and their matched general population controls, 2007–2016
| Cumulative antibiotic use | |||||
|---|---|---|---|---|---|
| No prior use | 1 prior dispensation | 2 prior dispensations | ≥3 prior dispensations | P-interaction | |
| Inflammatory bowel disease (IBD)# | |||||
| Broad-spectrum antibiotics | <0·0001 | ||||
| Cases, n (%) | 9,677 (57) | 3,690 (22) | 1,592 (9) | 2,040 (12) | |
| Controls, n (%) | 56,240 (66) | 16,302 (19) | 5,803 (7) | 6,620 (8) | |
| Multivariable OR (95% CI)‡ | 1·0 (ref) | 1·31 (1·25, 1·37) | 1·58 (1·48, 1·68) | 1·69 (1·59, 1·79) | |
| Narrow-spectrum antibiotics | |||||
| Cases n (%) | 9,677 (44) | 5,212 (24) | 2,797 (13) | 4,109 (19) | |
| Controls n (%) | 56,240 (52) | 25,023 (23) | 11,768 (11) | 15,134 (14) | |
| Multivariable OR (95% CI) | 1·0 (ref) | 1·18 (1·13, 1·22) | 1·37 (1·30, 1·43) | 1·49 (1·43, 1·56) | |
| Ulcerative colitis (UC) | |||||
| Broad-spectrum antibiotics | <0·0001 | ||||
| Cases n (%) | 6,587 (60) | 2,440 (21) | 1,015 (9) | 1,299 (11) | |
| Controls n (%) | 37,642 (66) | 10,934 (19) | 3,873 (7) | 4,465 (8) | |
| Multivariable OR (95% CI) | 1·0 (ref) | 1·29 (1·22, 1·36) | 1·50 (1·38, 1·63) | 1·57 (1·45, 1·70) | |
| Narrow-spectrum antibiotics | |||||
| Cases n (%) | 6,587 (45) | 3,524 (24) | 1,779 (11) | 2,590 (18) | |
| Controls n (%) | 37,642 (52) | 16,571 (23) | 7,775 (11) | 9,750 (14) | |
| Multivariable OR (95% CI) | 1·0 (ref) | 1·20 (1·15, 1·26) | 1·28 (1·21, 1·36) | 1·43 (1·35, 1·52) | |
| Crohn’s disease (CD) | |||||
| Broad-spectrum antibiotics | <0·0001 | ||||
| Cases n (%) | 3,030 (54) | 1,236 (22) | 587 (11) | 729 (13) | |
| Controls n (%) | 18,255 (66) | 5,277 (19) | 1,909 (7) | 2,130 (8) | |
| Multivariable OR (95% CI) | 1·0 (ref) | 1·40 (1·29, 1·52) | 1·79 (1·60, 2·00) | 1·78 (1·59, 1·99) | |
| Narrow-spectrum antibiotics | |||||
| Cases n (%) | 3,030 (42) | 1,667 (23) | 1,003 (14) | 1,497 (21) | |
| Controls n (%) | 18,255 (51) | 8,310 (23) | 3,933 (11) | 5,317 (15) | |
| Multivariable OR (95% CI) | 1·0 (ref) | 1·21 (1·13, 1·30) | 1·50 (1·37, 1·63) | 1·57 (1·44, 1·70) | |
Cumulative dispensations accrued from study baseline up until one year prior to diagnosis/match.
Abbreviations: OR - odds ratio, CI - confidence interval
#
Includes ulcerative colitis, Crohn’s disease, and IBD-unclassified
†
Conditional logistic regression matched for age, sex, and county. Referent group is no antibiotic use of any kind.
‡
Further adjusted for number of inpatient and outpatient encounters and education level