Dental Tribune International

Researchers link increased use of antibiotics to Parkinson’s disease

By Dental Tribune International
November 29, 2019

HELSINKI, Finland: Antibiotic overprescribing continues to be a major concern in dentistry. In most cases, readily prescribing antibiotics to patients before a dental treatment does not ensure effective and appropriate dental care intervention. Additionally, it accelerates antibiotic resistance. A recent study has found that higher exposure to commonly used oral antibiotics, especially broad-spectrum antibiotics and those that act against anaerobic bacteria and fungi, may also increase the risk of developing Parkinson’s disease.

In a case-control study, the researchers extracted data from national registries and compared antibiotic exposure between 1998 and 2014 in 13,976 Parkinson’s disease patients with 40,697 non-affected persons matched for age, sex and place of residence. Antibiotic exposure was examined over three different periods: one to five years, five to ten years and ten to 15 years before the index date, based on oral antibiotic purchase data.

Owing to the disruptive effects of antibiotics on the gut microbial ecosystem, the findings suggested that excessive use of certain antibiotics can predispose patients to Parkinson’s disease, with a delay of up to ten to 15 years.

“The link between antibiotic exposure and Parkinson’s disease fits the current view that in a significant proportion of patients the pathology of Parkinson’s may originate in the gut, possibly related to microbial changes, years before the onset of typical Parkinson motor symptoms such as slowness, muscle stiffness and shaking of the extremities,” said lead author Dr Filip Scheperjans, a neurologist from Helsinki University Hospital based at the Neurocenter at Meilahti Hospitals in Helsinki.

“It was known that the bacterial composition of the intestine in Parkinson’s patients is abnormal, but the cause is unclear. Our results suggest that some commonly used antibiotics, which are known to strongly influence the gut microbiota, could be a predisposing factor.”

In the gut, pathological changes typical of Parkinson’s disease have been observed up to 20 years before diagnosis. The researchers have also associated symptoms such as constipation, irritable bowel syndrome and inflammatory bowel disease with a higher risk of developing the disease. Exposure to antibiotics has been shown to cause changes in the gut microbiome and their use was associated with an increased risk of several diseases, such as psychiatric disorders, Crohn’s disease and Parkinson’s.

“The discovery may also have implications for antibiotic prescribing practices in the future. In addition to the problem of antibiotic resistance, antimicrobial prescribing should also take into account their potentially long-lasting effects on the gut microbiome and the development of certain diseases,” Scheperjans concluded.

The study, titled “Antibiotic exposure and risk of Parkinson's disease in Finland: A nationwide case-control study”, was published online on 18 November 2019 in Movement Disorders, ahead of inclusion in an issue.

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