Cited by 88Parkinson's Disease Mechanisms and TreatmentsGut microbiota and healthAntibiotic Use and Resistance

Antibiotic Exposure and Risk of Parkinson's Disease in Finland: A Nationwide Case‐Control Study

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Mertsalmi, Tuomas H., Pekkonen, Eero, Scheperjans, Filip·2020·Movement Disorders

Abstract

Background: Gut microbiota alterations have been found in prodromal and established Parkinson's disease (PD). Antibiotic exposure can have long‐term effects on the composition of human intestinal microbiota, but a potential connection between antibiotic exposure and risk of PD has not been studied previously. Objective: To evaluate the impact of antibiotic exposure on the risk of PD in a nationwide, register‐based, case‐control study. Methods: We identified all patients who were diagnosed with PD in Finland during the years 1998 to 2014. Information was obtained on individual purchases of orally administered antibiotics during the years 1993 to 2014. We assessed the association between prior antibiotic exposure and PD using conditional logistic regression. Results: The study population consisted of 13,976 PD cases and 40,697 controls. The strongest connection with PD risk was found for oral exposure to macrolides and lincosamides (adjusted odds ratio up to 1.416; 95% confidence interval, 1.053–1.904). After correction for multiple comparisons, exposure to antianaerobics and tetracyclines 10 to 15 years before the index date, sulfonamides and trimethoprim 1 to 5 years before the index date, and antifungal medications 1 to 5 years before the index date were positively associated with PD risk. In post hoc analyses, further positive associations were found for broad‐spectrum antibiotics. Conclusions: Exposure to certain types of oral antibiotics seems to be associated with an elevated risk of PD with a delay that is consistent with the proposed duration of a prodromal period. The pattern of associations supports the hypothesis that effects on gut microbiota could link antibiotics to PD, but further studies are needed to confirm this. © 2019 International Parkinson and Movement Disorder Society

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Crossref · 10.1002/mds.27924

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Authors
Mertsalmi, T. H., Pekkonen, E., & Scheperjans, F.
Affiliations
University of Helsinki (FI)
Corresponding author
Scheperjans, Filip
Venue
Movement Disorders
Publisher
Wiley
Published
2019-11-18
Volume
35
Issue
3
Pages
431-442
ISSN
  • 0885-3185 (ISSN-L)
  • 1531-8257
OpenAlex
W2986017919
Cited by
88
References
43
Citations by year
2026: 8 · 2025: 13 · 2024: 15 · 2023: 10 · 2022: 16 · 2021: 18 · 2020: 7 · 2019: 1
FWCI
7.10
Type
journal article
Language
en
Open access
Locations
  • Movement Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Työväentutkimus Vuosikirja (submittedVersion)
Funders
  • The Academy of Finland (295724, 310835)
  • The Finnish Medical Foundation
  • The Finnish Parkinson Foundation
Topics
  • Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
Keywords
Parkinson's disease, antibiotic exposure, gut microbiota, macrolides, lincosamides, tetracycline, sulfonamides, trimethoprim, antifungal agents, broad-spectrum antibiotics, prodromal period, oral antibiotics
MeSH terms
Gastrointestinal Microbiome, Anti-Bacterial Agents, Finland, Humans, Parkinson Disease, Case-Control Studies

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