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Published on: August 30, 2018
Association between prior antibiotic therapy and subsequent risk of community-acquired infections: a systematic
Umer Malik1, David Armstrong1, Mark Ashworth1
1Department of Primary Care and Public Health Sciences, King's College London, Addison House, Guy's Campus, London SE1 1UL, UK.
Background:
Antibiotic use can have negative unintended consequences including disruption of the human microbiota, which is thought to protect against pathogen overgrowth. We conducted a systematic review to assess whether there is an association between exposure to antibiotics and subsequent risk of community-acquired infections.
Methods:
We searched MEDLINE, EMBASE and Web of Science for studies published before 30 June 2017, examining the association between antibiotic use and subsequent community-acquired infection. Infections caused by Clostridium difficile and fungal organisms were excluded. Studies focusing exclusively on resistant organism infections were also excluded.
Results:
Eighteen of 22588 retrieved studies met the inclusion criteria. From these, 16 studies reported a statistically significant association between antibiotic exposure and subsequent risk of community-acquired infection. Infections associated with prior antibiotic use included Campylobacter jejuni infection (one study), recurrent furunculosis (one study), invasive Haemophilus influenzae type b infection (one study), infectious mastitis (one study), meningitis (one study), invasive pneumococcal disease (one study), Staphylococcus aureus skin infection (one study), typhoid fever (two studies), recurrent boils and abscesses (one study), upper respiratory tract infection and urinary tract infection (one study) and Salmonella infection (five studies), although in three studies on Salmonella infection the effect was of marginal statistical significance.
Conclusions:
We found an association between prior antibiotic use and subsequent risk of a diverse range of community-acquired infections. Gastrointestinal and skin and soft tissue infections were most frequently found to be associated with prior antibiotic exposure. Our findings support the hypothesis that antibiotic use may predispose to future infection risk, including infections caused by both antibiotic-resistant and non-resistant organisms.
Insights
Antibiotic use is linked to an increased risk of future community-acquired infections, including gastrointestinal and skin infections. This highlights potential unintended consequences of antibiotic exposure on human health.
Area of Science:
- Microbiology
- Infectious Diseases
- Pharmacology
Background:
- Antibiotic use can disrupt the human microbiota, potentially increasing susceptibility to pathogen overgrowth.
- The human microbiota plays a crucial role in protecting against infections.
Purpose of the Study:
- To systematically review and assess the association between antibiotic exposure and the subsequent risk of community-acquired infections.
- To investigate if prior antibiotic use predisposes individuals to infections.
Main Methods:
- A systematic review of studies was conducted, searching MEDLINE, EMBASE, and Web of Science.
- Studies published before June 30, 2017, were included, excluding Clostridium difficile, fungal, and exclusively resistant organism infections.
Main Results:
- Out of 22,588 retrieved studies, 18 met the inclusion criteria.
- Sixteen studies reported a significant association between antibiotic exposure and subsequent community-acquired infections.
- Commonly associated infections included gastrointestinal (e.g., Salmonella) and skin/soft tissue infections.
Conclusions:
- Prior antibiotic use is associated with an increased risk of diverse community-acquired infections.
- Findings support the hypothesis that antibiotics can predispose individuals to future infections, including those caused by non-resistant organisms.
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