Meta-analysiscited by the Tayebat archiveabstract only checked★ key study A-ABX-07 in-depth review
Antibiotics and Crohn's disease (meta-analysis)
Antibiotics associated with increased risk of new-onset Crohn's disease but not ulcerative colitis: a meta-analysis.
Overview
Ungaro R et al.. Am J Gastroenterol 2014 · PMID 25223575 · DOI 10.1038/ajg.2014.246
Antibiotic exposure was linked to higher odds of Crohn's disease, especially in children.
Does the study support the specific claim? Partly · Methodological quality: moderate
Plain-language summary
Study explained simply
- What did the researchers want to find out?
Pool studies.
- How was the study done?
Meta-analysis.
- How many people, animals or samples were studied?
11 studies.
- What was actually found?
Higher CD odds.
- How large was the observed effect?
OR 1.74; children 2.75.
- What do the results mean in everyday life?
Association, not proof.
- What are the study's limitations?
Observational.
- What does it say about Elawady's specific claim?
Supports association.
- Do the results apply to Germany and Europe?
Moderate.
- What can explicitly not be concluded from this study?
Causation.
Scientific in-depth review
1. Full reference
- Authors
- Ungaro R, Bernstein CN, Gearry R, Hviid A, Kolho KL, Kronman MP, Shaw S, Van Kruiningen H, Colombel JF, Atreja A
- Journal
- Am J Gastroenterol
- Year
- 2014
- Identifier
- PMID 25223575 DOI 10.1038/ajg.2014.246
- Verification
- verified – PubMed E-utilities efetch, 2026-10-25
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
not stated in abstract/record
2. Research question
Is antibiotic exposure a risk factor for new-onset IBD?
3. Study design and population
- Study design
- Meta-analysis – Meta-analysis of 11 observational studies (8 case-control, 3 cohort)
- Population
7208 IBD patients
- Country
Multinational
- Period
to 2014
- Sample size
11 studies; 7208 cases
- Inclusion and exclusion criteria
Studies of antibiotic exposure before IBD diagnosis
4. Methods and endpoints
- Exposure / intervention
Any antibiotic
- Comparator
Unexposed
- Endpoints
CD, UC, IBD
- Statistical methods
Random-effects
5. Actual results
- Results
IBD OR 1.57 (1.27-1.94); CD OR 1.74 (1.35-2.23); UC OR 1.08 (0.91-1.27); CD in children OR 2.75 (1.72-4.38); metronidazole OR 5.01; fluoroquinolones OR 1.79.
- Absolute risks
not reported
- Authors' conclusion
Antibiotics appear to increase odds of new CD, not UC; most marked in children.
6. Strengths
- Pooled data
7. Weaknesses
- Observational studies only
- Heterogeneity not in abstract
8. Risk of bias
- Orienting tool
- AMSTAR 2
- Type of assessment
- simplified assessment (abstract only)
- Full formal assessment
- no
- Overall risk of bias
- some concerns
- Rationale
Primary studies prone to protopathic bias.
9. Assessment of the statistical interpretation
Odds ratios.
10. Relevance to the specific claim
11. Independent contrary findings
12. Transferability to Germany and Europe
Moderate.
13. Overall methodological judgement
Consistent association.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | moderate |
| Directness | direct |
| Reproducibility | partly replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | moderate |
| Adequacy of the interpretation (by the archive) | essentially correct but incomplete |
14. Open questions
Causality.
15. Linked fact checks
Use by the Tayebat archive
Note: according to the archive, the studies were compiled by the archive operators. Whether Dr. Elawady himself cited this study is not established.
- What the archive says about the study
Meta-analysis linking antibiotic exposure to a 74% increase in new-onset Crohn's disease, rising to 2.75-fold in children; AR headline: 'proves' (يُثبت).
- A. What was actually studied?
Antibiotics and IBD.
- B. What did the authors find?
CD OR 1.74; children 2.75; UC null.
- C. What conclusions do the authors themselves draw?
'Appears to increase'.
- D. What does the archive derive from it?
AR headline says the meta-analysis 'proves' (يُثبت) the link.
- E. Is this derivation scientifically justified?
Numbers correct; 'proves' overstates observational evidence; OR is not the same as % risk increase.
- Adequacy of the interpretation (by the archive)
- essentially correct but incomplete