Antibiotic consumption of inpatients with inflammatory bowel disease during 2015-2024 and future prediction: Evidence from a general hospital

doi:10.3748/wjg.v32.i4.115040

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jan 28, 2026; 32(4): 115040
Published online Jan 28, 2026. doi: 10.3748/wjg.v32.i4.115040

Antibiotic consumption of inpatients with inflammatory bowel disease during 2015-2024 and future prediction: Evidence from a general hospital

Wen Zeng, Wei-Kun Zhang, Duo Xu, Kun He, Yu-Ping Huang, Yu-Xi Liu, Hui-Fang Yang

Wen Zeng, Yu-Ping Huang, Yu-Xi Liu, Department of Public Health, The Central Hospital of Shaoyang, Shaoyang 422000, Hunan Province, China

Wen Zeng, Kun He, Hui-Fang Yang, College of Public Health, Ningxia Medical University, Yinchuan 750004, Ningxia Hui Autonomous Region, China

Wei-Kun Zhang, The Affiliated Shaoyang Hospital, Hengyang Medical School, University of South China, Shaoyang 422000, Hunan Province, China

Wei-Kun Zhang, Department of Urology, The Central Hospital of Shaoyang, Shaoyang 422200, Hunan Province, China

Duo Xu, Department of Gastroenterology, Xiangya Hospital, Central South University, Changsha 410000, Hunan Province, China

Yu-Ping Huang, School of Public Health, Hengyang Medical School, University of South China, Hengyang 421200, Hunan Province, China

Yu-Xi Liu, The School of Public Health, Guilin Medical University, Guilin 541000, Guangxi Zhuang Autonomous Region, China

Author contributions: Zeng W, Xu D and Yang HF contributed to concept and design; Zhang WK, He K, Huang YP and Liu YX contributed to acquisition, analysis, or interpretation of data; Zeng W and Zhang WK contributed to drafting of the manuscript; Yang HF contributed to critical review of the manuscript for important intellectual content.

Supported by the Natural Science Foundation of Hunan Province, No. 2024JJ7477; and the Shaoyang Science and Technology Plan Project, No. 2024GZ2025.

Institutional review board statement: This study adhered to the ethical principles of the Declaration of Helsinki, and the research protocol was approved by the Ethics Committee of Shaoyang Central Hospital (No. KY 2025-002-10).

Informed consent statement: In view of the retrospective nature of this study, the requirement for informed consent was waived.

Conflict-of-interest statement: The authors declare that they have no conflict of interest.

STROBE statement: The authors have read the STROBE Statement—a checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-a checklist of items.

Data sharing statement: The data underlying this article will be shared on reasonable request to the corresponding author.

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/

Corresponding author: Hui-Fang Yang, MD, Doctor, College of Public Health, Ningxia Medical University, No. 1160 Victory Street, Yinchuan 750004, Ningxia Hui Autonomous Region, China. joyceyhf@163.com

Received: October 11, 2025
Revised: November 21, 2025
Accepted: December 29, 2025
Published online: January 28, 2026
Processing time: 108 Days and 16.6 Hours

Abstract

BACKGROUND

Inflammatory bowel disease (IBD) is a chronic, gastrointestinal condition including ulcerative colitis and Crohn’s disease. Patients diagnosed with IBD are more susceptible to infections and frequently require antibiotics.

AIM

To analyze the antibiotic consumption of IBD inpatients and project future relevant trends.

METHODS

We retrospectively collected the demographic and antibiotic usage data from the IBD patients hospitalized between 2015 and 2024. The antibiotics were classified, and the consumption intensity was calculated. The appropriate statistical methods were applied to compare the differences between groups. The Monte Carlo simulation was used to forecast the antibiotic consumption from 2025 to 2027.

RESULTS

A total of 1985 hospitalizations and 372 antibiotic prescriptions were included in this work. The antibiotic-exposed patients were older, had longer hospital stays, and higher costs. Males and ulcerative colitis patients showed a higher antibiotic usage. The highest consumption was observed in 2019, 2022, and 2024. The common indications were intestinal infections and perioperative prophylaxis. Cephalosporins and β-lactam antimicrobials were most commonly used, while carbapenems and glycopeptide antibacterials increased during 2022-2024. Although the antibiotic usage rates decreased in 2020-2024 when compared to 2015-2019, the consumption intensity significantly increased. The Monte Carlo simulation projected a 170.0% (95% uncertainty interval: -42.1% to 689.7%) consumption increase by 2027.

CONCLUSION

These findings highlight the need to strengthen antibiotic stewardship and infection control strategies in IBD inpatient management to prevent further escalation of antimicrobial resistance.

Keywords: Inflammatory bowel disease; Inpatients; Ulcerative colitis; Crohn’s disease; Antibiotic consumption; Monte Carlo simulation

Core Tip: This retrospective study analyzed antibiotic consumption of hospitalized Inflammatory bowel disease patients and predicted future trends. Among hospitalized patients, the usage of antibiotics was higher in elderly patients, male patients, and those with ulcerative colitis. The study also found that although the overall usage rate has declined in recent years, the use of “last-resort” antibiotics has significantly increased. The Monte Carlo simulation predicts that antibiotic consumption will double by 2027. These findings indicate an urgent need for targeted antimicrobial management.