Paediatric Kidney Stone Development Linked with Antibiotic Use - European Medical Journal

Paediatric Kidney Stone Development Linked with Antibiotic Use

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THE PREVALENCE of kidney stones has increased by 70% in the past three decades, with 11% of men and 6% of women in the USA developing stones at least once in their lifetime. Now, results of a new study suggest that some oral antibiotics may negatively affect the intestinal microbiome, contributing to the development of kidney stones, particularly in children and adolescents.

Searching an electronic medical records database of 13 million UK patients who visited their doctor between 1994 and 2015, researchers identified 26,000 people with kidneys stones; this group was compared against a control group of 260,000 patients who had not developed the condition. By analysing these medical records, after controlling for age, race, sex, urinary tract infections, other medications, and other medical conditions, the authors found that several types of oral antibiotic (sulfas, cephalosporins, fluoroquinolones, nitrofurantoin, and broad-spectrum penicillins) were associated with an increased risk of developing kidney stones.

Notably, those patients who received sulfa antibiotics had two-times the risk of developing kidney stones compared to controls, and broad-spectrum penicillins represented a 27% risk increase. The high risk of stone development decreased over time but remained for years after the discontinuation of antibiotic exposure.

With antibiotics infamously overprescribed, this study lends support to arguments for more cautious antibiotic use: “Our findings suggest that antibiotic prescription practices represent a modifiable risk factor,” explained lead investigator Dr Gregory E. Tasian, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

Indeed, these findings are of paramount importance for children, for whom antibiotics are more commonly prescribed than adults. “The reasons for the increase [in risk] are unknown, but our findings suggest that oral antibiotics play a role, especially given that children are prescribed antibiotics at higher rates than adults,” concluded study co-author Dr Michelle Denburg, Children’s Hospital of Philadelphia.

Research is now being conducted in new directions to more thoroughly explore the relationship between antibiotics and the intestinal microbiome, and how this interaction can impact the development of kidney stones.

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