Antibiotic Use During Gastrointestinal Infections Increases the Risk of Developing Irritable Bowel Syndrome: A Systematic Review and Meta-Analysis.

It has been hypothesized that changes in gut microbiota composition and function evoked by antibiotic use represent a trigger for IBS development.

有假设认为，由抗生素使用引起的肠道微生物组成和功能的变化是IBS发展的触发因素。

This systematic reviewand meta-analysisaimed to assess the incidenceof IBS after antibiotic use.

这项系统评价和荟萃分析旨在评估抗生素使用后IBS的发生率。

Methods

Medline, Embase, and Scopus, along with relevant conference abstracts and citation tracking were searched up to June 15th, 2025.

检索了Medline、Embase和Scopus，以及相关的会议摘要和引文追踪，直到2025年6月15日。

Studies that reported new diagnoses of IBS in patients with documented antibiotic exposure vs controls without antibiotic exposure were included.

包括了报告在有记录的抗生素暴露患者中新的IBS诊断与无抗生素暴露对照组的研究。

Data extraction and quality assessment were performed independently by 2 reviewers.

数据提取和质量评估由2名审查员独立进行。

Pooled incidencerates per 1,000 person-years, along with incidencerate ratios (IRRs) with 95% confidence intervals (CI) were pooled; heterogeneity was expressed as I2 .

每1000人年的人群中，合并发病率以及95%置信区间（CI）的发病率比（IRRs）被合并；异质性以I2表示。

Metaregression analysis was performed to assess the impact of confounding covariates.

进行了元回归分析，以评估混杂协变量的影响。

Results

Thirty-one studies comprising a total of 422,350 patients (244,632 antibiotic users and 177,718 nonusers) were included.

共有31项研究，涉及422,350名患者（244,632名抗生素使用者和177,718名非使用者）被纳入分析。

The overall pooled incidenceof IBS was 26% in antibiotic users compared with 20% in nonusers, resulting in an IRR of 1.3 (95% CI: 1.07-1.58; P = 0.008).

抗生素使用者的肠易激综合症（IBS）总体合并发病率为26%，而非使用者为20%，导致发病率比（IRR）为1.3（95%置信区间：1.07-1.58；P = 0.008）。

In sensitivity analyses including only studies in which antibiotics were used for gastrointestinal infections, the risk of developing IBS was higher for antibiotic users (IRR: 1.71; 95% CI: 1.16-2.51; P = 0.007), with high heterogeneity ( I2 > 90%) among studies.

在仅包括抗生素用于胃肠道感染的研究的敏感性分析中，抗生素使用者发展为IBS的风险更高（IRR：1.71；95%置信区间：1.16-2.51；P = 0.007），研究间存在高度异质性（I2 > 90%）。

Geographical area, criteria for IBS diagnosis and study quality were associated with estimated effects, explaining the observed heterogeneity.

地理区域、IBS诊断标准和研究质量与估计效应相关，解释了观察到的异质性。

Discussion

Antibiotic use is associated with increased risk of developing IBS, especially after gastrointestinal infections.

抗生素使用与增加发展为IBS的风险相关，尤其是在胃肠道感染后。

However, the significant study heterogeneity reduces the power of our results, suggesting that further high-quality research is needed to clarify this relationship.

然而，显著的研究异质性降低了我们结果的效力，表明需要进一步的高质量研究来阐明这种关系。