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Antibiotic Use and Risk of Multiple Sclerosis: A Nested Case-Control Study in Emilia-Romagna Region, Italy. 2021
Elisa Baldin, and
Corrado Zenesini, and
Ippazio Cosimo Antonazzo, and
Ilaria Bartolomei, and
Luisa Caniatti, and
Manuela Costa, and
Erika Curti, and
Diana Ferraro, and
Matteo Foschi, and
Franco Granella, and
Angelica Guareschi, and
Paolo Immovilli, and
Alessandra Lugaresi, and
Susanna Malagù, and
Luca Mancinelli, and
Sara Montepietra, and
Vittoria Mussuto, and
Walter Neri, and
Marco Pasquinelli, and
Lisa Pellegrino, and
Ilaria Pesci, and
Elisabetta Poluzzi, and
Maura Pugliatti, and
Alessandro Ravasio, and
Trond Riise, and
Fabrizio Salvi, and
Mario Santangelo, and
Francesca Sireci, and
Patrizia Sola, and
Silvia Strumia, and
Elena Tsantes, and
Luca Vignatelli, and
Francesca Vitetta, and
Beatrice Viti, and
Roberto D'Alessandro, and
Epidemiology and Statistics Unit, IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy.
Known risk factors for multiple sclerosis (MS) include smoking, a low vitamin D status, obesity, and EBV, while the inflammatory feature of the disease strongly suggests the presence of additional infectious agents. The association between use of antibiotics and MS risk that could shed light on these factors is still undetermined. We aimed to evaluate the association between antibiotics and MS risk, in the Emilia-Romagna region (RER), Italy. All adult patients with MS seen at any RER MS center (2015-2017) were eligible. For each of the 877 patients included, clinical information was collected and matched to 5 controls (RER residents) (n = 4,205) based on age, sex, place of residence, and index year. Information on antibiotic prescription was obtained through the linkage with the RER drug prescription database. Exposure to any antibiotic 3 years prior to the index year was associated with an increased MS risk (OR = 1.52; 95% CI = 1.29-1.79). Similar results were found for different classes. No dose-response effect was found. Our results suggest an association between the use of antibiotics and MS risk in RER population. However, further epidemiological studies should be done with information on early life and lifestyle factors.
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