Table 3.
Association between cumulative dispensations of antibiotics and risk of colorectal polyps
| No prior use | 1 prior dispensation | 2 prior dispensations | 3–5 prior dispensations | ≥6 prior dispensations | P trend | |
|---|---|---|---|---|---|---|
| All antibiotics | ||||||
| No. of cases | 16,860 | 8,094 | 5,629 | 8,563 | 6,598 | |
| No. of sibling controls | 40,085 | 17,583 | 10,970 | 14,719 | 9,950 | |
| OR (95% CI)* | 1 (ref) | 0.95 (0.90–1.01) | 1.05 (0.98–1.12) | 1.19 (1.12–1.26) | 1.33 (1.25–1.43) | <0.0001 |
| Narrow-spectrum antibiotics | ||||||
| No. of cases | 22,279 | 9,482 | 5,267 | 5,982 | 2,734 | |
| No. of sibling controls | 49,854 | 19,115 | 9,906 | 10,152 | 4,280 | |
| OR (95% CI)* | 1 (ref) | 1.00 (0.95–1.05) | 1.02 (0.96–1.09) | 1.17 (1.10–1.25) | 1.19 (1.09–1.30) | 0.03 |
| Broad-spectrum antibiotics | ||||||
| No. of cases | 26,650 | 8,184 | 4,196 | 4,424 | 2,290 | |
| No. of sibling controls | 61,519 | 15,269 | 6,714 | 6,543 | 3,262 | |
| OR (95% CI)* | 1 (ref) | 1.12 (1.06–1.18) | 1.32 (1.23–1.42) | 1.37 (1.28–1.47) | 1.38 (1.25–1.52) | <0.0001 |
| Anti-aerobic antibiotics | ||||||
| No. of cases | 17,307 | 8,271 | 5,679 | 8,386 | 6,101 | |
| No. of sibling controls | 41,040 | 17,904 | 10,938 | 14,289 | 9,136 | |
| OR (95% CI)* | 1 (ref) | 0.95 (0.90–1.01) | 1.05 (0.98–1.11) | 1.19 (1.13–1.26) | 1.33 (1.24–1.43) | <0.0001 |
| Anti-anaerobic antibiotics | ||||||
| No. of cases | 41,414 | 2,965 | 793 | 439 | 133 | |
| No. of sibling controls | 85,925 | 5,189 | 1,229 | 728 | 236 | |
| OR (95% CI)* | 1 (ref) | 1.08 (1.00–1.17) | 1.20 (1.03–1.39) | 1.18 (0.97–1.44) | 0.76 (0.53–1.10) | 0.36 |
| Penicillin | ||||||
| No. of cases | 23,330 | 9,487 | 5,186 | 5,633 | 2,108 | |
| No. of sibling controls | 51,888 | 19,149 | 9,660 | 9,383 | 3,227 | |
| OR (95% CI)* | 1 (ref) | 0.98 (0.93–1.03) | 1.06 (0.99–1.13) | 1.14 (1.07–1.22) | 1.23 (1.11–1.36) | <0.0001 |
| Tetracyclines | ||||||
| No. of cases | 34,074 | 6,685 | 2,423 | 1,899 | 663 | |
| No. of sibling controls | 74,729 | 11,554 | 3,509 | 2,589 | 926 | |
| OR (95% CI)* | 1 (ref) | 1.13 (1.07–1.19) | 1.33 (1.22–1.46) | 1.37 (1.24–1.52) | 1.43 (1.20–1.69) | <0.0001 |
| Quinolones | ||||||
| No. of cases | 39,043 | 3,902 | 1,443 | 1,049 | 307 | |
| No. of sibling controls | 82,635 | 6,354 | 2,211 | 1,607 | 500 | |
| OR (95% CI)* | 1 (ref) | 1.20 (1.11–1.29) | 1.32 (1.18–1.49) | 1.16 (1.01–1.32) | 1.12 (0.88–1.42) | <0.0001 |
| Macrolides | ||||||
| No. of cases | 40,482 | 3,453 | 961 | 630 | 218 | |
| No. of sibling controls | 84,607 | 5,903 | 1,506 | 949 | 342 | |
| OR (95% CI)* | 1 (ref) | 1.12 (1.04–1.21) | 1.15 (1.00–1.32) | 1.33 (1.12–1.57) | 1.01 (0.76–1.36) | 0.08 |
| Sulfonamides and trimethoprim | ||||||
| No. of cases | 41,890 | 2,617 | 657 | 434 | 146 | |
| No. of sibling controls | 87,029 | 4,159 | 1,109 | 751 | 259 | |
| OR (95% CI)* | 1 (ref) | 1.19 (1.10–1.30) | 1.09 (0.92–1.28) | 1.09 (0.89–1.34) | 1.06 (0.76–1.48) | 0.31 |
| Cephalosporins and other non-penicillin beta-lactams | ||||||
| No. of cases | 43,064 | 2,045 | 408 | 176 | 51 | |
| No. of sibling controls | 88,721 | 3,541 | 663 | 317 | 65 | |
| OR (95% CI)* | 1 (ref) | 1.17 (1.07–1.29) | 1.01 (0.82–1.25) | 0.89 (0.64–1.22) | 1.11 (0.57–2.18) | 0.09 |
| Other classes | ||||||
| No. of cases | 42,785 | 1,786 | 502 | 415 | 256 | |
| No. of sibling controls | 88,183 | 3,098 | 862 | 725 | 439 | |
| OR (95% CI)* | 1 (ref) | 1.11 (1.00–1.23) | 1.10 (0.91–1.33) | 1.04 (0.84–1.27) | 0.83 (0.64–1.08) | 0.20 |
*
Multivariable conditional logistic regression model was adjusted for age (continuous), sex (binary), year of birth (continuous), income levels (quintiles), education (9 years or less, 10–12 years, >12 years, missing), total number of prior clinic visits (quintiles), Charlson comorbidity score (continuous), and major comorbidities (all binary, including diabetes, cardiovascular disease, non-colorectal cancer, liver disease, chronic pulmonary disease, connective tissue disease, and peptic ulcer disease).