Antibiotic prescriptions are associated with a higher risk of rheumatoid arthritis (RA), according to a study published online in BMC Medicine.

Alyshah Abdul Sultan, Ph.D., from Keele University in the United Kingdom, and colleagues used data from the primary care Clinical Practice Research Datalink to identify 22,677 patients with an incident diagnosis of RA (1995 to 2017). Cases were matched to 90,013 controls without RA, based on age, gender, and general practice.

The researchers found that over a median follow-up of 10 years before RA diagnosis, the odds of developing RA were higher in those exposed to antibiotics (odds ratio [OR], 1.60), compared to those not exposed. There was a dose- or frequency-dependent association between the number of previous antibiotic prescriptions and RA. The odds of RA were higher for all classes of antibiotics, with bactericidal antibiotics carrying higher risk than bacteriostatic (45 versus 31 percent). RA cases were most likely among those treated with antibiotics for upper respiratory tract infections. There were also increased odds of RA seen with antifungal (OR, 1.27) and antiviral (OR, 1.19) prescriptions.

"Antibiotic prescriptions are associated with a higher risk of RA," the authors write. "This may be due to microbiota disturbances or underlying infections driving risk."

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