Meta-analysisindependent cross-checkabstract checked I-ABX-118 standard review
Childhood antibiotics linked to later Crohn's disease
Systematic review and meta-analysis of childhood exposure to antibiotics and the subsequent risk of IBD.
Overview
Størdal K et al.. Inflamm Bowel Dis 2026 · PMID 41617205 · DOI 10.1093/ibd/izaf324
Pooled studies show about 59% higher relative risk of Crohn's disease after childhood antibiotics.
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 on childhood antibiotics and IBD
- How was the study done?
Meta-analysis
- How many people, animals or samples were studied?
10 studies
- What was actually found?
Higher IBD risk, especially Crohn's
- How large was the observed effect?
CD RR 1.59 (1.39-1.81)
- What do the results mean in everyday life?
A moderate relative increase in a rare disease
- What are the study's limitations?
Observational
- What does it say about Elawady's specific claim?
Supports an association but not a doubling
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Whether antibiotics cause IBD
Scientific in-depth review
1. Full reference
- Authors
- Størdal K et al.
- Journal
- Inflamm Bowel Dis
- Year
- 2026
- Identifier
- PMID 41617205 DOI 10.1093/ibd/izaf324
- Verification
- verified – PubMed efetch 2026-10-26 + Crossref
- Retracted
- no
- Corrections
- none
- Extent checked
- abstract only
- Conflicts of interest and funding
None declared (record).
2. Research question
Is childhood antibiotic use associated with later IBD?
3. Study design and population
- Study design
- Meta-analysis – Systematic review and meta-analysis of cohort and case-control studies
- Population
Children exposed <1 to 17 years
- Country
Multinational
- Period
Searches to 31 December 2024
- Sample size
10 studies (8 IBD, n=2783 cases)
- Inclusion and exclusion criteria
Cohort/case-control studies reporting HR/OR/RR
4. Methods and endpoints
- Exposure / intervention
Childhood antibiotics
- Comparator
No antibiotics
- Endpoints
IBD, Crohn's disease, ulcerative colitis
- Statistical methods
DerSimonian-Laird random effects
5. Actual results
- Results
IBD RR 1.42 (95% CI 1.23-1.66); CD RR 1.59 (1.39-1.81); UC RR 1.23 (1.08-1.40); I2 0-35%; no evidence of publication bias; adjustment for infections did not attenuate the association.
- Absolute risks
not reported
- Authors' conclusion
Childhood antibiotic exposure was associated with increased risk of later IBD, particularly CD; causal interpretation should be cautious.
6. Strengths
- Recent
- Low heterogeneity
- Infection adjustment examined
7. Weaknesses
- Observational studies only
- Few studies
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
Observational inputs.
9. Assessment of the statistical interpretation
CD RR 1.59 is well below a doubling.
10. Relevance to the specific claim
Most direct and recent pooled estimate for children.
11. Independent contrary findings
Shows the 'near-doubling' wording overstates the pooled effect.
12. Transferability to Germany and Europe
High.
13. Overall methodological judgement
Consistent moderate association; doubling not supported by newest pooled estimate.
| Multidimensional assessment | |
|---|---|
| Authenticity of the source | verified |
| Methodological quality | moderate |
| Risk of bias | some concerns |
| Precision of results | high |
| Directness | direct |
| Reproducibility | replicated |
| Consistency with the overall evidence | consistent |
| Regional transferability | high |
| Adequacy of the interpretation (by the archive) | not applicable |
14. Open questions
Causality.