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Antibiotic use and inflammatory bowel disease: number needed to harm?
  1. Jonas F Ludvigsson
  1. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  1. Correspondence to Professor Jonas F Ludvigsson, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 17177, Sweden; jonas.ludvigsson{at}

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I read the paper by Faye et al1 with great excitement and want to commend the authors for their careful and thorough analysis. The potential side effects of antibiotics have lately attracted increased attention and my research group has also published on the association between antibiotics and inflammatory bowel disease (IBD).2 Both our papers indicate a link between the use of antibiotics and later IBD.

I agree that antibiotic stewardship is needed to limit the development of multidrug resistant organisms, but whether such stewardship will reduce the risk of IBD remains obscure. In this respect, Faye et al1 acknowledge that unmeasured confounding may have played a role in their results (as in every observational study, …

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  • Contributors JFL is the sole author.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests JFL has started a collaboration with first author Faye on another IBD topic and coordinated a study on behalf of the Swedish IBD quality register (SWIBREG). That study received funding from Janssen corporation. JFL has also received financial support from MSD developing a paper reviewing national healthcare registers in China.

  • Provenance and peer review Not commissioned; internally peer reviewed.