{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T15:37:26Z","timestamp":1764085046733,"version":"3.37.3"},"reference-count":45,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,2,15]],"date-time":"2016-02-15T00:00:00Z","timestamp":1455494400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"crossref","award":["259764"],"award-info":[{"award-number":["259764"]}],"id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100003125","name":"Finnish Cultural Foundation","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100003125","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Intl J Eating Disorders"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>We examined the use of antimicrobial medication as a proxy for infections in large patient cohort treated for binge\u2010eating disorder (BED), bulimia nervosa (BN), and anorexia nervosa (AN) over the five\u2010year period preceding eating disorder treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>Patients (<jats:italic>N<\/jats:italic>\u2009=\u20091592) at the Eating Disorder Unit of Helsinki University Central Hospital between 2000 and 2010 were compared with matched general population controls (<jats:italic>N<\/jats:italic>\u2009=\u20096368). The study population was linked to the prescription data of antibacterial, antifungal and antiviral medication from the Register on Reimbursed Prescription Medicine. Data were analyzed using regression models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Individuals with BN and BED had received more often antimicrobial medication prescriptions compared to their controls (OR: 1.7, 95% CI: 1.3\u20132.1; OR: 2.6, 95% CI: 1.4\u20134.6, respectively), while no significant difference emerged in AN (OR: 0.9, 95% CI: 0.7\u20131.0, <jats:italic>p<\/jats:italic>\u2009=\u20090.10). Of the main drug categories, the respective pattern was seen in antibacterial and antifungal medication, while increased use for antivirals appeared only in BN (OR: 1.6, 95% CI: 1.1\u20132.3). Measured with the mean number of prescriptions or mean Defined Daily Doses per individual, patients with BN, BED and males with AN had also higher total antimicrobial medication use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>Indicating increased infections, we found elevated use of antimicrobial medication in BN, BED and in males with AN. Infections may be consequence of hyperglycemia, weight gain, or dysregulation of intestinal microbiota associated with core eating disorder behaviors. Or the other way round; changes in intestinal microbiota due to infections, inflammation, or antibacterial medications might contribute to eating disorders in multiple ways. \u00a9 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:542\u2013552)<\/jats:p><\/jats:sec>","DOI":"10.1002\/eat.22497","type":"journal-article","created":{"date-parts":[[2016,2,15]],"date-time":"2016-02-15T11:35:56Z","timestamp":1455536156000},"page":"542-552","source":"Crossref","is-referenced-by-count":17,"title":["Increased use of antimicrobial medication in bulimia nervosa and binge\u2010eating disorder prior to the eating disorder treatment"],"prefix":"10.1002","volume":"49","author":[{"given":"Anu","family":"Raevuori","sequence":"first","affiliation":[{"name":"Clinicum Department of Public Health University of Helsinki  Finland"},{"name":"Department of Adolescent Psychiatry Helsinki University Central Hospital Helsinki Finland"},{"name":"Institute of Clinical Medicine, Child Psychiatry, University of Turku  Finland"},{"name":"Department of Mental Health and Substance Abuse Services National Institute for Health and Welfare Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Lukkariniemi","sequence":"additional","affiliation":[{"name":"Clinicum Department of Public Health University of Helsinki  Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaana T.","family":"Suokas","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Substance Abuse Services National Institute for Health and Welfare Helsinki Finland"},{"name":"Department of Psychiatry Helsinki University Central Hospital  Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mika","family":"Gissler","sequence":"additional","affiliation":[{"name":"Information Services Department National Institute for Health and Welfare Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaana M.","family":"Suvisaari","sequence":"additional","affiliation":[{"name":"Department of Mental Health and Substance Abuse Services National Institute for Health and Welfare Helsinki Finland"},{"name":"Department of Social Psychiatry Tampere School of Public Health  Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jari","family":"Haukka","sequence":"additional","affiliation":[{"name":"Clinicum Department of Public Health University of Helsinki  Finland"},{"name":"Department of Mental Health and Substance Abuse Services National Institute for Health and Welfare Helsinki Finland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,15]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2567.1998.00548.x"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0306-4530(02)00021-5"},{"key":"e_1_2_7_4_1","doi-asserted-by":"crossref","first-page":"1520","DOI":"10.1001\/archinte.1978.03630350050015","article-title":"Leukopenia in anorexia nervosa: Lack of increased risk of infection","volume":"138","author":"Bowers TK","year":"1978","journal-title":"Arch Intern Med"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/pgmj.54.632.395"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1586\/1744666X.2.3.433"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/1469-0691.12157"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20610"},{"key":"e_1_2_7_9_1","doi-asserted-by":"crossref","first-page":"485S","DOI":"10.1093\/ajcn\/66.2.485S","article-title":"Interactions between nutrition and immunity in anorexia nervosa: A 1\u2010y follow\u2010up study","volume":"66","author":"Marcos A","year":"1997","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(67)90066-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-64-2-328"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20135"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.10189"},{"key":"e_1_2_7_14_1","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1093\/ajcn\/57.1.65","article-title":"Evaluation of immunocompetence and nutritional status in patients with bulimia nervosa","volume":"57","author":"Marcos A","year":"1993","journal-title":"Am J Clin Nutr"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2005.06.058"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiph.2012.12.007"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1461145702003024"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2013.1111"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1523\/JNEUROSCI.3299-14.2014"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2974"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI72333"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2014.05.052"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.11.034"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.20462"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2013.07.042"},{"volume-title":"International statistical classification of disease, 10th revision (ICD\u201010)","year":"1992","author":"World Health Organization","key":"e_1_2_7_26_1"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_7_28_1","unstructured":"WHO Collaborating Centre for Drug Statistics Methodology Guidelines for ATC classification and DDD assignment 2014. Oslo 2013."},{"key":"e_1_2_7_29_1","unstructured":"BreslowNE DayNE.Statistical methods in cancer research. I\u2015The analysis of case\u2010control studies. Lyon: International Agency for Research on Cancer 1980."},{"volume-title":"R: A Language and Environment for Statistical Computing","year":"2011","author":"R Development Core Team","key":"e_1_2_7_30_1"},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.1097\/YCO.0000000000000113"},{"key":"e_1_2_7_32_1","doi-asserted-by":"publisher","DOI":"10.1093\/ajcn\/66.2.460S"},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1043-4526(06)52002-9"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2005.01626.x"},{"key":"e_1_2_7_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.imbio.2012.07.010"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000000177"},{"key":"e_1_2_7_37_1","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1097\/SLA.0b013e3182a501e3","article-title":"The clinical significance of an elevated postoperative glucose value in nondiabetic patients after colorectal surgery: Evidence for the need for tight glucose control?","volume":"258","author":"Kiran RPM","year":"2013","journal-title":"Ann Surg"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2013.05.110"},{"key":"e_1_2_7_39_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-307913"},{"key":"e_1_2_7_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eatbeh.2004.08.009"},{"key":"e_1_2_7_41_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.88.6.952"},{"key":"e_1_2_7_42_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2249.1990.tb05127.x"},{"key":"e_1_2_7_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.22153"},{"key":"e_1_2_7_44_1","doi-asserted-by":"publisher","DOI":"10.1002\/eat.1017"},{"key":"e_1_2_7_45_1","doi-asserted-by":"publisher","DOI":"10.1089\/cap.2014.0073"},{"key":"e_1_2_7_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbi.2013.04.006"}],"container-title":["International Journal of Eating Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Feat.22497","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/eat.22497","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T07:10:35Z","timestamp":1696576235000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/eat.22497"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,15]]},"references-count":45,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2016,6]]}},"alternative-id":["10.1002\/eat.22497"],"URL":"https:\/\/doi.org\/10.1002\/eat.22497","archive":["Portico"],"relation":{},"ISSN":["0276-3478","1098-108X"],"issn-type":[{"type":"print","value":"0276-3478"},{"type":"electronic","value":"1098-108X"}],"subject":[],"published":{"date-parts":[[2016,2,15]]}}}