Uso de antibióticos e desenvolvimento de doença inflamatória intestinal em crianças.

Abstract

Inflammatory bowel diseases represent a group of conditions that include Crohn's Disease, Ulcerative Colitis, and Indeterminate Colitis. These chronic pathologies result from an autoimmune inflammatory response leading to gastrointestinal tract lesions, presenting symptoms such as abdominal pain, bloody diarrhea, and nutrient malabsorption. It is estimated that 25% to 30% of all cases of inflammatory bowel disease begin before the age of 20, with a direct correlation observed between disease morbidity and the age of onset. The etiopathogenesis of these diseases is believed to involve an interaction among genetic, immunological, and environmental factors; one hypothesis emphasizes alterations in gut microbiota as a triggering factor. Thus, antibiotic use during childhood and disruption of the microbiome are potential risk factors for the development of inflammatory bowel diseases in children. The objective of this study is to discuss the relationship between antibiotic use in childhood and the development of inflammatory bowel diseases in children. An integrative literature review was conducted using the descriptors: inflammatory bowel disease, crohn disease, colitis, ulcerative, antimicrobial agents, antibiotics, antimicrobials, anti-bacterial agents, child, children, pediatric, and infant. The consulted databases included PubMed, LILACS, and MedLine, covering the period from 2009 to August 2024. The results were obtained from nine articles selected through critical reading and organized into synoptic tables. The studies indicated an association between antibiotic use in childhood and the development of inflammatory bowel diseases in children, with this association appearing more pronounced when exposure occurred in the first years of life and proportional to the number of antibiotic doses received. This correlation seems stronger in cases of Crohn's disease than in ulcerative colitis cases, and is more common following exposure to beta-lactams and macrolides. Further studies are needed to better clarify the influence of antibiotic exposure on the development of inflammatory bowel diseases in children, and measures should be taken in pediatric healthcare to minimize this effect.