- •There is the controversy between the results of studies that have investigated the relationship between antibiotic use and multiple sclerosis.
- •Five individual studies with 47,491 participants included in this meta-analysis.
- •There was no significant association between antibiotic use and the risk of MS.
- •There was no significant association between penicillin use and the risk of MS.
: Epidemiological studies have shown conflicting results between antibiotic use and multiple sclerosis (MS) risks. The present systematic review and meta-analysis were conducted to assess the association between antibiotic use and the risk of MS.
: PubMed, Scopus, Embase, Web of Science, and Google Scholar as well as reference lists of retrieved studies were searched systematically to identify studies were assessed the relationship between antibiotic use and MS up to September 24, 2022. Random-effects model was used for the calculation of pooled Odds ratio (OR) and 95% confidence intervals (CI).
: Five independent studies containing 47,491 participants were included in the meta-analysis. The overall results of included studies showed a non-significant positive association between antibiotic use (OR overall=1.01, 95%CI: 0.75–1.37) and a non-significant negative association between penicillin use (OR overall= 0.83; 95%CI: 0.62–1.13) and MS risk. Heterogeneity was (I2=90.1, P heterogeneity < 0.001) and (I2=90.7, P heterogeneity < 0.001) in antibiotics and penicillin use groups respectively.
: Our meta-analysis did not show a significant association between antibiotic or penicillin use with the risk of MS. However, due to the limitations of this study, further well-designed studies are required to confirm our findings.
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- Antibiotic use and risk of multiple sclerosis: a nested case-control study in Emilia-Romagna region.Italy. Neuroepidemiology. 2021; 55: 224-231
- Epidemiology and natural history of multiple sclerosis: new insights.Curr. Opin. Neurol. 2006; 19: 248-254
- Multiple sclerosis and birth order: a longitudinal cohort study.Lancet Neurol. 2005; 4: 611-617
- Chlamydia pneumoniae infection and the risk of multiple sclerosis: a meta-analysis.Mult. Scler. J. 2006; 12: 397-411
- Use of penicillin and other antibiotics and risk of multiple sclerosis: a population-based case-control study.Am. J. Epidemiol. 2011; 174: 945-948
- Infectious exposure, antibiotic use, and multiple sclerosis: a population-based incident case-control study.Acta Neurol. Scand. 2018; 138: 308-314
- Allergies, antibiotics use, and multiple sclerosis.Curr. Med. Res. Opin. 2017; 33: 1451-1456
- Long-term antibiotic treatment with roxithromycin in patients with multiple sclerosis.Infection. 2006; 34: 342-344
- Antibiotic use and risk of multiple sclerosis.Am. J. Epidemiol. 2006; 163: 997-1002
- The Newcastle-Ottawa scale (NOS) for assessing the quality of nonrandomised studies in meta-analyses.Oxford, 2000
- Quantifying heterogeneity in a meta-analysis.Stat. Med. 2002; 21: 1539-1558
- Meta-analysis in clinical trials.Control. Clin. Trials. 1986; 7: 177-188
- Antibiotic self-medication among non-medical university students in Punjab, Pakistan: a cross-sectional survey.Int. J. Environ. Res. Public Health. 2017; 14: 1152
- Use of antibiotics without a prescription in the US population: a scoping review.Ann. Intern. Med. 2019; 171: 257-263
- Factors influencing inappropriate use of antibiotics: findings from a nationwide survey of the general public in Malaysia.PLOS One. 2021; 16e0258698
- Correlation between antibiotic consumption and the occurrence of multidrug-resistant organisms in a Malaysian tertiary hospital: a 3-year observational study.Sci. Rep. 2022; 12: 3106
- A systematic review and meta-analysis of the effects of antibiotic consumption on antibiotic resistance.BMC Infect. Dis. 2014; 14: 1-25
- Infections and multiple sclerosis.Handb. Clin. Neurol. 2014; 122: 151-171
World Health Organization. Antimicrobial stewardship programmes in health-care facilities in low-and middle-income countries: a WHO practical toolkit. 2019. Available from: https://www.who.int/publications-detail-redirect/9789241515481.
Published online: May 14, 2023
Accepted: May 14, 2023
Received in revised form: April 16, 2023
Received: February 13, 2023
© 2023 Elsevier B.V. All rights reserved.