The possibility that environmental factors influence the development of inflammatory bowel disease (IBD) is raised by several pieces of epidemiologic evidence, including a higher prevalence of IBD in industrialized societies.' Along with the increased understanding of the role of the gut micro-biome in the inflammatory cascade of IBD2 has emerged the thought that antibiotic use may be one such etiologic agent.Shaw et al3 is the latest investigation into whether antibiotics may be one of the environmental factors that contribute to the onset of IBD. This study was performed by querying an administrative database from Manitoba, Canada, where there is a single health insurance payor and a linkable prescription database that was instituted in 1995. Accordingly, the authors were able to generate population-based data on the rate at which antibiotics were prescribed before 1 year of age to all children who went on to develop new-onset IBD between the years 1996-2008.
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