Objective:

To determine whether antibiotic or antifungal exposure increases the risk of developing Parkinson’s disease (PD).

Background:

A prior study suggested that adults who received >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.

Design/Methods:

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.

Results:

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 >2 penicillin doses (OR 0.92, CI 0.86-0.99, p = 0.02).  Exposure to >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 >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 >2 doses of antifungals 1-5 years prior to ID and increased PD risk (p = 0.06).

Conclusions:

We found a borderline association between penicillin exposure and reduced risk of PD, but increased PD risk after antifungal exposure.