History of antibiotic use and risk of non‐Hodgkin's lymphoma (NHL)

Abstract

A population-based, incidence case-control study was conducted among women in upstate New York to determine whether histories of certain infections and antibiotic use are associated with risk of non-Hodgkin's lymphoma (NHL). Our study involved 376 cases of NHL identified through the New York State Cancer Registry and 463 controls selected from the Medicare beneficiary files and state driver's license records. Information about use of common medications including antibiotics, history of selected infectious diseases and potential confounding variables was obtained by telephone interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using an unconditional logistic regression model. There was a progressive increase in risk of NHL with increasing frequency and duration of systemic antibiotic use, as assessed over the period of 2-20 years before the interview. The ORs for the highest exposure categories, >36 episodes and >366 days of use, were 2.56 (95% CI 1.33-4.94) and 2.66 (95% CI 1.35-5.27), respectively. These associations were primarily due to antibiotic use against respiratory infections and dental conditions. Moreover, the association with frequency of antibiotic use for respiratory infections was pronounced for marginal zone B-cell lymphoma and for respiratory tract lymphoma. Analyses by class of antibiotics did not suggest that a general cytotoxic effect of antibiotics was responsible for these increased risks. Although recall bias and selection bias remain potential concerns in our study, the results are generally consistent with the hypothesis that persistent infection/inflammation predisposes individuals to the development of NHL. However, a direct role of antibiotics in NHL induction has not been ruled out.

Joint effect between regular use of non-steroidal anti-inflammatory drugs, variants in inflammatory genes and risk of lymphoma

“…For a stratified analysis the group of concomitant users was too small and could not be performed. Corticosteroids, which were previously associated with an increased risk of lymphoma [13,15,79], did not modulate risk in this study (OR = 1.1, 95% CI = 0.6-2.0). This is in line with data from several other studies [14,[80][81][82].…”

Effects of Antibiotics on Gut Microbiota

“…It is conceivable that patients who have a weakened immune system - as this is one of the risks of malignant diseases - more easily develop infections that require the use of antibiotics. This would explain why in other studies a higher risk of malignancy, for example, non-Hodgkin's lymphoma [84] or breast cancer [85] were also described, without suggesting that antibiotic-caused changes in the microbiota were the potential cause of these malignancies.…”

Risk of Multiple Myeloma following Medication Use and Medical Conditions: A Case-Control Study in Connecticut Women

“…Use of various medications, such as antibiotics (20)(21)(22), nonsteroidal anti-inflammatory drugs and other analgesics (20,(23)(24)(25), corticosteroids and other immunosuppressants (20,23,(26)(27)(28)(29), histamine2 receptor antagonists (30,31), psychotropic drugs (20,28,32), anticonvulsants (33)(34)(35), estrogen replacement therapy (20,36), antidepressants or antianxiety drugs (37,38), amphetamines (38), and digitalis or digitoxin (20,39), has been associated with risk of nonHodgkin's lymphoma (NHL). However, to our knowledge, there is very little information on medication use and subsequent risks of multiple myeloma or other lymphoproliferative malignancies.…”