Antibiotics: at what age is their use dangerous, and which organ do they destroy the most

People over 40 who take antibiotics often face an increased risk of developing inflammatory bowel diseases such as Crohn’s disease and ulcerative colitis, a new US-Danish study shows.

The risk increases with regular use of antibiotics and is highest one to two years after their use, especially if they are targeted pharmaceuticals (fighting intestinal infections).

Researchers led by Adam Fay of New York University Langone Medical Center, who published data in the gastroenterology journal Gut, analyzed data on more than 6.1 million people, of whom 91% received at least one course of antibiotics between 2000 and 2018 year. During this period, 36,017 people were diagnosed with ulcerative colitis and 16,681 with Crohn’s disease.

In addition, people aged 10–40 years were 28% more likely to be diagnosed with ulcerative colitis, those aged 40–60 years were 48% more likely, and those over 60 years old were 47% more likely. The risk of Crohn’s disease was slightly higher than the above disease: 40% in persons aged 10-40 years, 62% in persons aged 40-60 years and 51% in persons over 60 years of age.

Each additional antibiotic treatment increased the risk by 11%, 15% and 14% depending on the age group, respectively. Thus, those who took antibiotics more than five times during the previous 20 years, the risk increased by 69% (10-40 years), 100%, i.e. doubled (40-60 years old), and 95% (over 60 years old).

In other studies, it appears increasing evidence that various environmental factors are involved in the development of inflammatory bowel disease. Globally, approximately seven million people suffer from this disease, and the number of patients is predicted to increase over the next decade.

The new study shows that, among other things, antibiotics, especially fluoroquinolones and nitroimidazoles, which are commonly used to treat intestinal infections, increase the associated risk. Other common antibiotics, such as penicillins, increase the risk to a much lesser extent.

The reason for the increased risk is likely due to the fact that antibiotics change the microbiome (flora) of the gut. Therefore, according to the researchers, limiting antibiotics to absolutely necessary not only reduces the development of resistant microbes, but also the risk of developing inflammatory bowel disease, especially after 40 years.

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