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Oral antibiotics may raise risk of kidney stones

Children and adults treated with some oral antibiotics have a higher risk of developing kidney stones, paediatric researchers have suggested.

Researchers said this is the first time these medicines have been linked to this condition. The strongest risks appeared at younger ages, and also among patients most recently exposed to antibiotics.

Commenting on the findings, study leader Dr Gregory Tasian, a paediatric urologist at Children’s Hospital of Philadelphia (CHOP), said: “The overall prevalence of kidney stones has risen by 70% over the past 30 years, with particularly sharp increases among adolescents and young women.” He added that kidney stones were previously rare in children.

Study co-author Dr Michelle Denburg, a paediatric nephrologist at CHOP, said the reasons for the increase were unknown, “but our findings suggest that oral antibiotics play a role, especially given that children are prescribed antibiotics at higher rates than adults”.

The study team drew on information from electronic health records from the UK, covering 13 million adults and children seen by general practitioners in the Health Improvement Network between 1994 and 2015. The team analysed prior antibiotic exposure for nearly 26,000 patients with kidney stones, compared to nearly 260,000 control subjects.

They found that five classes of oral antibiotics were associated with a diagnosis of kidney stone disease. The five classes were oral sulfas, cephalosporins, fluoroquinolones, nitrofurantoin, and broad-spectrum penicillins.

After adjustments for age, sex, race, urinary tract infection, other medications and other medical conditions, patients who received sulfa drugs were more than twice as likely as those not exposed to antibiotics to have kidney stones. For broad-spectrum penicillins, the increased risk was 27% higher.

The strongest risks for kidney stones were in children and adolescents. The risk of kidney stones decreased over time but remained elevated several years after antibiotic use.

The study was published in the Journal of the American Society of Nephrology.