Antibiotic exposure and risk of Parkinson's disease in the United Kingdom: A case-control study (P5-11.001)

Abstract

<h3>Objective:</h3> To determine whether antibiotic or antifungal exposure increases the risk of developing Parkinson’s disease (PD). <h3>Background:</h3> A prior study suggested that adults who received &gt;1 course of anti-anaerobic or tetracycline antibiotics had an increased PD risk 10–15 years after exposure, while antifungal medication exposure was associated with an increased PD risk 1–10 years later. <h3>Design/Methods:</h3> A nested case-control study was used to examine the association between antimicrobial exposure with newly diagnosed PD using the Clinical Practice Research Datalink (CPRD), a primary care UK database. Each case was matched to up to 15 controls by age, year of registration, sex, and practice, at time of PD diagnosis (index date, ID). Number of prescribed antimicrobial courses was assessed 1–5, 5–10, and 10–15 years prior to ID. Conditional logistic regression was used to estimate odds ratios (ORs) with 95% confidence intervals (CIs) between antimicrobial exposure and risk of PD adjusted for relevant covariates. <h3>Results:</h3> We compared 19,022 PD cases to 120,447 matched controls. Exposure to one dose of penicillin 1–5 years prior to ID was associated with increased PD risk (OR 1.07, CI 1.0–1.13, p = 0.04), but reduced PD risk with exposure to &gt;2 penicillin doses (OR 0.92, CI 0.86–0.99, p = 0.02). Exposure to &gt;5 penicillin doses 1–10 years prior to ID was associated with reduced PD risk. Adjusting for multiple comparisons, there was a trend towards significance regarding reduced PD risk with exposure to &gt;5 penicillin doses 1–5 (p = 0.06) and 6–10 years (p = 0.09) prior to ID. A trend towards significance was found with exposure to &gt;2 doses of antifungals 1–5 years prior to ID and increased PD risk (p = 0.06). <h3>Conclusions:</h3> We found a borderline association between penicillin exposure and reduced risk of PD, but increased PD risk after antifungal exposure. <b>Disclosure:</b> Dr. Pal has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Guidepoint. Dr. Pal has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Kyowa Kirin. Dr. Pal has stock in Baudax Bio. The institution of Dr. Pal has received research support from National Institutes of Health. The institution of Dr. Pal has received research support from Parkinson’s Foundation. Dr. Bennett has stock in Bristol Myers Squibb. Dr. Bennett has stock in Merck. Dr. Bennett has stock in Cigna. Dr. Bennett has stock in Organon. Dr. Roy has nothing to disclose. Dr. Nyandege has nothing to disclose. Dr. Mouradian has received personal compensation in the range of $500-$4,999 for serving as a Consultant for HanAll Biopharma. Dr. Mouradian has received personal compensation in the range of $50,000-$99,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Society for Experimental Neurotherapeutics. Dr. Mouradian has stock in Alnylam, Eli Lilly. The institution of Dr. Mouradian has received research support from NIH, Michael J. Fox Foundation for Parkinson’s Research; American Parkinson Disease Association. Dr. Mouradian has received intellectual property interests from a discovery or technology relating to health care. Dr. Mouradian has a non-compensated relationship as a Board of Directors with ANA that is relevant to AAN interests or activities. Dr. Gerhard has nothing to disclose. Daniel Horton has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Childhood Arthritis and Rheumatology Research Alliance. Daniel Horton has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Pharmacoepidemiology &amp; Drug Safety. The institution of Daniel Horton has received research support from Danisco USA Inc. The institution of Daniel Horton has received research support from Childhood Arthritis and Rheumatology Research Alliance/Arthritis Foundation. Daniel Horton has received personal compensation in the range of $0-$499 for serving as a Consultant with US Food &amp; Drug Administration. Daniel Horton has received personal compensation in the range of $500-$4,999 for serving as a Guideline Development Team Member, Speaker with American College of Rheumatology.