Insights on the Association between Antimicrobial Use and Risk of Parkinson's Disease: A Systematic Review and Meta-Analysis.

Introduction: Gut dysbiosis is one of the environmental factors that might contribute to the development of Parkinson's disease (PD). The potential impact of antimicrobial agents on PD risk, particularly through dysbiosis and neuroinflammation, is an area of ongoing investigation, though findings remain inconsistent.

Methods: This systematic review and meta-analysis aimed to assess the relationship between antimicrobial use and PD risk. After searching PubMed, Scopus, Web of Science, and Embase, ten studies involving 3,755,583 participants, including 52,974 PD patients, were included.

Results: Antibacterial use was not significantly correlated with PD risk (odds ratio [OR] = 1.14; 95% CI: 0.97-1.33; p = 0.11, I2 = 84%). After excluding one study, the odds of PD became significantly higher (OR = 1.22; 95% CI: 1.04-1.44; p = 0.01). Specific antibacterial classes, such as tetracyclines and macrolides, showed no significant associations with PD. However, cephalosporins had a protective effect (OR = 0.86; p = 0.04), while antifungal use increased PD risk (OR = 1.16; p = 0.001). Regarding antiviral use, a significant reduction in PD risk was observed in patients with hepatitis C virus undergoing antiviral treatment (HR = 0.69; p = 0.0008).

Conclusion: The findings indicate complex relationships between antimicrobial use and PD risk. While antibacterials, in general, tend to increase PD risk, specific antibacterial may offer a protective effect, while antifungal agents appear to increase PD risk. Antiviral therapy may reduce PD risk in HCV patients. Further research is needed to confirm our results.