I Abdollahpour1, S Nedjat2, M A Mansournia3, S Eckert4, B Weinstock-Guttman5. 1. Department of Epidemiology, School of Public Health, Arak University of Medical Sciences, Arak, Iran. 2. Department of Epidemiology and Biostatistics, School of Public Health, Knowledge Utilization Research Center, Tehran University of Medical Sciences, Tehran, Iran. 3. Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran. 4. University at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA. 5. Neurology, Jacobs School of Medicine and Biomedical Science, University of Buffalo, Buffalo, NY, USA.
Abstract
BACKGROUND: The existing reports regarding the potential role of infections as well as antibiotic use in multiple sclerosis (MS) etiology are inconclusive. OBJECTIVES: We aimed to investigate the association of viral infections as well as antibiotic use and the risk of developing MS. MATERIALS & METHODS: This was a population-based incident case-control study of 547 incident cases and 1057 general population controls obtained from 22 municipality areas of Tehran (7/8/2013-17/2/2015). Multiple logistic regression models were used to determine the adjusted associations. RESULTS: Overall antibiotic use for ≥14 days during 3 years before the index date, significantly decreased the odds of MS OR 0.69 (95%CI: 0.53-0.91, P = .008). The results were consistent for different types of antibiotics, including penicillin OR 0.50 (95%CI: 0.34-0.75, P = .001) and cephalosporins OR 0.25 (95%CI: 0.12-0.50, P < .001). History of IM was associated with a more than 5fold increased risk of MS OR = 5.7 (95%CI, 1.28-25.37). There was no statistically significant association between any other single or cumulative number of viral infections with subsequent risk of MS (P > .05). CONCLUSIONS: Considering the possibility of reverse causation, the results of this large case-control study suggest that use of antibiotics may be associated with a decreased risk of MS. However, viral disease other than infectious mononucleosis was not associated with MS risk.
BACKGROUND: The existing reports regarding the potential role of infections as well as antibiotic use in multiple sclerosis (MS) etiology are inconclusive. OBJECTIVES: We aimed to investigate the association of viral infections as well as antibiotic use and the risk of developing MS. MATERIALS & METHODS: This was a population-based incident case-control study of 547 incident cases and 1057 general population controls obtained from 22 municipality areas of Tehran (7/8/2013-17/2/2015). Multiple logistic regression models were used to determine the adjusted associations. RESULTS: Overall antibiotic use for ≥14 days during 3 years before the index date, significantly decreased the odds of MS OR 0.69 (95%CI: 0.53-0.91, P = .008). The results were consistent for different types of antibiotics, including penicillin OR 0.50 (95%CI: 0.34-0.75, P = .001) and cephalosporins OR 0.25 (95%CI: 0.12-0.50, P < .001). History of IM was associated with a more than 5fold increased risk of MS OR = 5.7 (95%CI, 1.28-25.37). There was no statistically significant association between any other single or cumulative number of viral infections with subsequent risk of MS (P > .05). CONCLUSIONS: Considering the possibility of reverse causation, the results of this large case-control study suggest that use of antibiotics may be associated with a decreased risk of MS. However, viral disease other than infectious mononucleosis was not associated with MS risk.
Authors: GÁbor TernÁk; KÁroly BerÉnyi; Gergely MÁrovics; AndrÁs SÜmegi; Barbara Fodor; BalÁzs NÉmeth; IstvÁn Kiss Journal: In Vivo Date: 2020 Nov-Dec Impact factor: 2.155