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

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.