- Some oral antibiotics
significantly increase the risk of developing kidney stones.
- Children are the most affected, as they are prescribed more antibiotics than adults.
- Oral sulfas, cephalosporins,
fluoroquinolones, nitrofurantoin, and broad-spectrum penicillins were
associated with increased risk of kidney stones.
For the first time, it was found that children
and adults treated with some oral antibiotics had a significantly higher risk
of developing kidney stones.
The risk was more strongly observed in children as they are prescribed
antibiotics at much higher rates than adults. The study is published in the Journal of the
American Society of Nephrology.
Kidney stones are hard mineral and salt
deposits that form inside your kidneys. They can affect any part of your
urinary tract from the kidneys to the bladder. Kidney stones are often
manageable and easy to treat, if identified early. While these are common in
adults, the occurrence in children was previously rare. However, now there
seems to be a rise in the prevalence of kidney stones among children
"The overall prevalence of kidney stones
has risen by 70 percent over the past 30 years, with particularly sharp
increases among adolescents and young women," said study leader Gregory E.
Tasian, MD, MSCE, a pediatric
urologist at Children's
Hospital of Philadelphia (CHOP).
‘Children and adults treated with some oral antibiotics are at increased risk for developing kidney stones.’
Co-author Michelle Denburg, MD, MSCE, a pediatric
nephrologist at CHOP, added,
"The reasons for the increase are unknown, but our findings suggest
that oral antibiotics play a role, especially given that children are
prescribed antibiotics at higher rates than adults."
Data was collected from
the electronic health records from the United Kingdom. The study included 13
million adults and children seen by general practitioners in the Health
Improvement Network between 1994 and 2015. The research team analyzed prior
antibiotic exposure for nearly 26,000 patients with kidney
nearly 260,000 control subjects.
Five classes of oral
antibiotics were associated with a diagnosis of kidney stones; these were: oral
sulfas, cephalosporins, fluoroquinolones, nitrofurantoin
, and broad-spectrum penicillins.
- Patients who received sulfa drugs
were more than twice as likely as those not exposed to antibiotics to have
- Patients who received
broad-spectrum penicillins, the increased risk was 27% higher.
- The strongest risks for kidney
stones were found in children and adolescents. While the risk of kidney
stones decreased over time, the elevated level of antibiotics remained
several years after antibiotic use.
suggest that antibiotic prescription practices represent a modifiable risk
factor—a change in prescribing patterns might decrease the current epidemic of
kidney stones in children," Tasian said.
- Gregory E. Tasian1, Thomas Jemielita, David S. Goldfarb, Lawrence Copelovitch, Jeffrey S. Gerber, Qufei Wu and Michelle R. Denburg "Oral Antibiotic Exposure and Kidney Stone Disease" Journal of the American Society of Nephrology (2018), doi: 10.1681/ASN.2017111213