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Acid Suppression and Antibiotics Administered during Infancy Are Associated with Celiac Disease.
Boechler, Michael; Susi, Apryl; Hisle-Gorman, Elizabeth; Rogers, Philip L; Nylund, Cade M.
Afiliação
  • Boechler M; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD. Electronic address: Michael.a.boechler.mil@health.mil.
  • Susi A; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD.
  • Hisle-Gorman E; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
  • Rogers PL; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD.
  • Nylund CM; Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD.
J Pediatr ; 254: 61-67.e1, 2023 03.
Article em En | MEDLINE | ID: mdl-36265574
OBJECTIVE: To investigate why certain at-risk individuals develop celiac disease (CD), we examined the association of proton pump inhibitors (PPI), histamine-2 receptor antagonists (H2RAs), and antibiotic prescriptions in the first 6 months of life with an early childhood diagnosis of CD. STUDY DESIGN: A retrospective cohort study was performed using the Military Healthcare System database. Children with a birth record from October 1, 2001, to September 30, 2013, were identified. Outpatient prescription records were queried for antibiotic, PPI, and H2RA prescriptions in the first 6 months of life. Cox proportional hazards regression was used to calculate the hazard ratio (HR) of developing CD based on medication exposure. International Classification of Diseases, Ninth Revision, Clinical Modification codes identified children with an outpatient visit for CD. RESULTS: There were 968 524 children who met the inclusion criteria with 1704 cases of CD in this group. The median follow-up for the cohort was approximately 4.5 years. PPIs (HR, 2.23; 95% CI, 1.76-2.83), H2RAs (HR, 1.94; 95% CI, 1.67-2.26), and antibiotics (HR, 1.14; 95% CI, 1.02-1.28) were all associated with an increased hazard of CD. CONCLUSIONS: There is an increased risk of developing CD if antibiotics, PPIs and H2RAs are prescribed in the first 6 months of life. Our study highlights modifiable factors, such as medication stewardship, that may change the childhood risk of CD.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença Celíaca / Antibacterianos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Humans / Infant Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Doença Celíaca / Antibacterianos Tipo de estudo: Observational_studies / Prognostic_studies / Risk_factors_studies Limite: Child / Child, preschool / Humans / Infant Idioma: En Revista: J Pediatr Ano de publicação: 2023 Tipo de documento: Article País de publicação: Estados Unidos