TY - JOUR
T1 - Association of doxycycline use with the development of gastroenteritis, irritable bowel syndrome and inflammatory bowel disease in Australians deployed abroad
AU - Lee, Thomas
AU - Russell, Lahiru
AU - Deng, Minfeng
AU - Gibson, Peter Raymond
PY - 2013
Y1 - 2013
N2 - Background: The risks are unknown for developing chronic gastrointestinal illness
when personnel are relocated short term to other countries and when taking antibiotic
prophylaxis in areas where malaria is endemic.
Aim: To examine the associations of deployment to developed or developing countries
and exposure to doxycycline with the new onset of acute gastroenteritis, irritable bowel
syndrome (IBS) and inflammatory bowel disease (IBD).
Methods: A cross-sectional web-based survey of all current and past members of the
Australian Federal Police Association was undertaken. Independent predictors of
gastrointestinal illness were examined by logistic regression analysis relative to those
not deployed without exposure to doxycycline.
Results: Of 1300 respondents (response rate 34 ), 133 were excluded due to preexisting
chronic gastrointestinal illness. Five hundred and ninety had episodes of overseas
deployment for a median duration of 6.5 (range 0.1?149) months. Eighteen (3 )
of those not deployed took doxycycline compared with 171 (30 ) of those deployed.
The risk of acute gastroenteritis was associated with deployment itself without clear
association with doxycycline. Doxycycline exposure was associated with increased onset
of IBS in those deployed to developing (odds ratio [OR], 6.99; 95 confidence interval
[CI], 3.19?15.31) and developed country (OR, 6.93; 95 CI, 1.40?34.39). New onset of
IBD (1.5 ) was associated with deployment to developed countries and with
doxycycline exposure (OR, 8.75; 95 CI, 1.67?45.86)).
Conclusions: The use of doxycycline is a risk factor for developing IBS and possibly
IBD when deployed to developing and developed countries respectively. Doxycycline as
a risk factor for chronic gastrointestinal illness warrants a prospective large-scale study.
AB - Background: The risks are unknown for developing chronic gastrointestinal illness
when personnel are relocated short term to other countries and when taking antibiotic
prophylaxis in areas where malaria is endemic.
Aim: To examine the associations of deployment to developed or developing countries
and exposure to doxycycline with the new onset of acute gastroenteritis, irritable bowel
syndrome (IBS) and inflammatory bowel disease (IBD).
Methods: A cross-sectional web-based survey of all current and past members of the
Australian Federal Police Association was undertaken. Independent predictors of
gastrointestinal illness were examined by logistic regression analysis relative to those
not deployed without exposure to doxycycline.
Results: Of 1300 respondents (response rate 34 ), 133 were excluded due to preexisting
chronic gastrointestinal illness. Five hundred and ninety had episodes of overseas
deployment for a median duration of 6.5 (range 0.1?149) months. Eighteen (3 )
of those not deployed took doxycycline compared with 171 (30 ) of those deployed.
The risk of acute gastroenteritis was associated with deployment itself without clear
association with doxycycline. Doxycycline exposure was associated with increased onset
of IBS in those deployed to developing (odds ratio [OR], 6.99; 95 confidence interval
[CI], 3.19?15.31) and developed country (OR, 6.93; 95 CI, 1.40?34.39). New onset of
IBD (1.5 ) was associated with deployment to developed countries and with
doxycycline exposure (OR, 8.75; 95 CI, 1.67?45.86)).
Conclusions: The use of doxycycline is a risk factor for developing IBS and possibly
IBD when deployed to developing and developed countries respectively. Doxycycline as
a risk factor for chronic gastrointestinal illness warrants a prospective large-scale study.
UR - http://onlinelibrary.wiley.com/doi/10.1111/imj.12179/pdf
U2 - 10.1111/imj.12179
DO - 10.1111/imj.12179
M3 - Article
SN - 1444-0903
VL - 43
SP - 919
EP - 926
JO - Internal Medicine Journal
JF - Internal Medicine Journal
IS - 8
ER -