Related Experiment Video
Updated: May 24, 2025
Multiplex Therapeutic Drug Monitoring by Isotope-dilution HPLC-MS/MS of Antibiotics in Critical Illnesses
Published on: August 30, 2018
Antibiotic drug use in the five years preceding the diagnosis of multiple sclerosis
Sonia Darvishi1, Ewan Donnachie2, Paula Anne Uibel1
1Department of Neurology, Klinikum rechts der Isar, School of Medicine and Health, Technical University of Munich, Munich, Germany.
Background:
Microbiota may play a role in autoimmune disease pathogenesis, including multiple sclerosis (MS). Antibiotic use disrupts the microbiome and may increase the risk of autoimmune diseases. We evaluated the relationship between MS diagnosis and antibiotic, antimycotic and antiviral drug use in the 5 years preceding diagnosis.
Method:
Our population-based case-control study used German ambulatory claims data from 2012 to 2022. We defined cohorts of 13,053 MS patients, 22,898 Crohn's disease patients, and 15,037 matched controls without autoimmune diseases, aged 21-70. Logistic and Poisson regression models explored the relationship between MS diagnosis and antimicrobial usage. Two sub-analyses were performed: a separate analysis of patients with clinically isolated syndrome (CIS) and a sensitivity analysis of newly diagnosed MS patients without preceding neurological symptoms.
Results:
Patients with MS had higher exposure to antibiotic (Odd Ratio (OR) = 1.27, 95 % CI 1.21-1.33), antimycotic (OR = 1.27, 95 % CI 1.12-1.45), and antiviral drugs (OR = 1.28, 95 % CI 1.15-1.43) in the five years before diagnosis compared to patients with no autoimmune diseases. Similar findings were obtained for the CIS cohort and in the sensitivity analysis. Antibiotic use peaked 5 years before MS diagnosis, declining closer to diagnosis, while antiviral and antimycotic drug use showed the opposite. This effect was not observed in the sensitivity analysis and CIS cohorts. Antibiotic use was higher in Crohn's disease than in MS (OR = 0.86, 95 % CI 0.82-0.90), with no consistent differences in antimycotic and antiviral use.
Conclusions:
The association and kinetic of antibiotic use before MS and CIS diagnosis supports the role of microbiota in MS pathogenesis and suggests antibiotic use to be related to the development of autoimmune diseases, including MS. Additional studies are warranted to clarify whether increased antibiotic use is part of the MS prodrome or a true risk factor for MS.
Insights
Antibiotic, antimycotic, and antiviral drug use in the five years before diagnosis was higher in multiple sclerosis (MS) patients, suggesting a link between antimicrobial exposure and MS development. Further research is needed to confirm if this is a risk factor or part of the MS prodrome.
Area of Science:
- Immunology
- Microbiology
- Neurology
Background:
- Microbiota influences autoimmune disease pathogenesis, including multiple sclerosis (MS).
- Disruption of the microbiome via antibiotic use may elevate autoimmune disease risk.
- The study investigates the association between MS diagnosis and antimicrobial drug use prior to diagnosis.
Purpose of the Study:
- To evaluate the relationship between multiple sclerosis (MS) diagnosis and the use of antibiotic, antimycotic, and antiviral drugs within the five years preceding diagnosis.
- To explore the potential role of microbiota in MS pathogenesis.
- To determine if antimicrobial drug usage is a risk factor for developing MS.
Main Methods:
- Population-based case-control study utilizing German ambulatory claims data (2012-2022).
- Cohorts included 13,053 MS patients, 22,898 Crohn's disease patients, and 15,037 matched controls.
- Logistic and Poisson regression models analyzed antimicrobial usage; sub-analyses included clinically isolated syndrome (CIS) and newly diagnosed MS patients.
Main Results:
- MS patients showed increased exposure to antibiotics (OR=1.27), antimycotics (OR=1.27), and antivirals (OR=1.28) in the five years before diagnosis compared to controls.
- Similar trends were observed in CIS and newly diagnosed MS cohorts.
- Antibiotic use peaked five years prior to MS diagnosis, decreasing closer to diagnosis, unlike antimycotic and antiviral drug use.
Conclusions:
- The association between pre-diagnostic antimicrobial use and MS supports the role of microbiota in MS pathogenesis.
- Findings suggest antibiotic use may be related to the development of autoimmune diseases like MS.
- Further studies are required to ascertain if increased antibiotic use is a prodromal symptom or a causative risk factor for MS.
Related Concept Videos
01:27Combined Effects of Drugs: Synergism
Such synergistic combinations...
01:29Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents
01:18Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents
01:29Pulmonary Tuberculosis I
Causative Organism
The primary infectious agent causing tuberculosis is Mycobacterium tuberculosis, a slow-growing, acid-fast, aerobic rod that exhibits sensitivity to heat and ultraviolet light. Instances of Mycobacterium bovis and Mycobacterium avium contributing to the development of TB infection are rare.
Mode of...
00:57Antibiotic Selection
01:15Myasthenia Gravis: Diagnostic Tests
The edrophonium test is a diagnostic tool for myasthenia gravis. It involves...