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The relationship between prior antimicrobial prescription and meningitis: a case–control study

Armstrong, D, Ashworth, M, Dregan, A and White, P (2016) The relationship between prior antimicrobial prescription and meningitis: a case–control study British Journal of General Practice, 66 (645). e228-e233.

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Background Recent research into the role of the human microbiome in maintaining health has identified the potentially harmful impact of antimicrobials. Aim The association with bacterial and viral meningitis following antimicrobial prescription during the previous year was investigated to determine whether antimicrobials have a deleterious effect on the nasopharyngeal microbiome. Design and setting A case-control study (1:4 cases to controls) was conducted examining the rate of previous antimicrobial exposure in cases of meningitis and in a matched control group. Data from a UK primary care clinical database were analysed using conditional logistic regression. Results A total of 7346 cases of meningitis were identified, 3307 (45%) viral, 1812 (25%) bacterial, and 2227 (30%) unspecified. The risks of viral (adjusted odds ratio [AOR] 2.45; 95% confidence interval [CI] = 2.24 to 2.68) or bacterial (AOR 1.98; 95% CI = 1.71 to 2.30) meningitis were both increased following antimicrobial prescription in the preceding year. Patients who received ≥4 antimicrobial prescriptions in the preceding year were at significantly increased risk of all types of meningitis (AOR 2.85; 95% CI = 2.44 to 3.34), bacterial meningitis (AOR 3.06; 95% CI = 2.26 to 4.15) and viral meningitis (AOR 3.23; 95% CI = 2.55 to 4.08) compared to their matched controls. Conclusion There was an increased risk of meningitis following antimicrobial prescription in the previous year. It is possible that this increase was due to an effect of antimicrobials on the microbiome or reflected an increased general susceptibility to infections in these patients.

Item Type: Article
Subjects : Biosciences
Divisions : Surrey research (other units)
Authors :
Ashworth, M
Dregan, A
White, P
Date : April 2016
DOI : 10.3399/bjgp16X684313
Copyright Disclaimer : © 2016 British Journal of General Practice
Uncontrolled Keywords : Antimicrobial agents, Case-control studies, Meningitis, Microbiome, Primary care
Depositing User : Symplectic Elements
Date Deposited : 17 May 2017 10:48
Last Modified : 24 Jan 2020 20:04

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