{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T02:35:00Z","timestamp":1791167700079,"version":"4.1.0"},"reference-count":34,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2012,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>To determine whether childhood antianaerobic antibiotic exposure is associated with the development of inflammatory bowel disease (IBD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>This retrospective cohort study employed data from 464 UK ambulatory practices participating in The Health Improvement Network. All children with \u22652 years of follow-up from 1994 to 2009 were followed between practice enrollment and IBD development, practice deregistration, 19 years of age, or death; those with previous IBD were excluded. All antibiotic prescriptions were captured. Antianaerobic antibiotic agents were defined as penicillin, amoxicillin, ampicillin, penicillin\/\u03b2-lactamase inhibitor combinations, tetracyclines, clindamycin, metronidazole, cefoxitin, carbapenems, and oral vancomycin.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>A total of 1\u2009072\u2009426 subjects contributed 6.6 million person-years of follow-up; 748 developed IBD. IBD incidence rates among antianaerobic antibiotic unexposed and exposed subjects were 0.83 and 1.52\/10\u2009000 person-years, respectively, for an 84% relative risk increase. Exposure throughout childhood was associated with developing IBD, but this relationship decreased with increasing age at exposure. Exposure before 1 year of age had an adjusted hazard ratio of 5.51 (95% confidence interval [CI]: 1.66\u201318.28) but decreased to 2.62 (95% CI: 1.61\u20134.25) and 1.57 (95% CI: 1.35\u20131.84) by 5 and 15 years, respectively. Each antibiotic course increased the IBD hazard by 6% (4%\u20138%). A dose-response effect existed, with receipt of &amp;gt;2 antibiotic courses more highly associated with IBD development than receipt of 1 to 2 courses, with adjusted hazard ratios of 4.77 (95% CI: 2.13\u201310.68) versus 3.33 (95% CI: 1.69\u20136.58).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>Childhood antianaerobic antibiotic exposure is associated with IBD development.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2011-3886","type":"journal-article","created":{"date-parts":[[2012,9,25]],"date-time":"2012-09-25T00:27:03Z","timestamp":1348532823000},"page":"e794-e803","source":"Crossref","is-referenced-by-count":396,"title":["Antibiotic Exposure and IBD Development Among Children: A Population-Based Cohort Study"],"prefix":"10.1542","volume":"130","author":[{"given":"Matthew P.","family":"Kronman","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Seattle Children\u2019s Hospital, University of Washington, Seattle, Washington;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theoklis E.","family":"Zaoutis","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania; and"},{"name":"Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kevin","family":"Haynes","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Feng","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan E.","family":"Coffin","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, The Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania; and"},{"name":"Department of Biostatistics and Epidemiology, the Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2012,10,1]]},"reference":[{"issue":"8","key":"2021120823511070300_B1","doi-asserted-by":"crossref","first-page":"955","DOI":"10.1038\/ng.175","article-title":"Genome-wide association defines more than 30 distinct susceptibility loci for Crohn\u2019s disease.","volume":"40","author":"Barrett","year":"2008","journal-title":"Nat Genet"},{"issue":"7","key":"2021120823511070300_B2","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1136\/gut.29.7.990","article-title":"Ulcerative colitis and Crohn\u2019s disease in an unselected population of monozygotic and dizygotic twins. 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