The Impact of Oral Antibiotics Prior to Cancer Diagnosis on Overall Patient Survival: Findings from an English Population-Based Cohort Study.
CPRD
antibiotics
antimicrobial resistance
cancer therapy
Journal
Current oncology (Toronto, Ont.)
ISSN: 1718-7729
Titre abrégé: Curr Oncol
Pays: Switzerland
ID NLM: 9502503
Informations de publication
Date de publication:
15 Sep 2023
15 Sep 2023
Historique:
received:
29
07
2023
revised:
09
09
2023
accepted:
12
09
2023
medline:
27
9
2023
pubmed:
27
9
2023
entrez:
27
9
2023
Statut:
epublish
Résumé
There is limited evidence in humans as to whether antibiotics impact the effectiveness of cancer treatments. Rodent studies have shown that disruption in gut microbiota due to antibiotics decreases cancer therapy effectiveness. We evaluated the associations between the antibiotic treatment of different time periods before cancer diagnoses and long-term mortality. Using the Clinical Practice Research Datalink GOLD, linked to the Cancer Registry's and the Office for National Statistics' mortality records, we delineated a study cohort that involved cancer patients who were prescribed antibiotics 0-3 months; 3-24 months; or more than 24 months before cancer diagnosis. Patients' exposure to antibiotics was compared according to the recency of prescriptions and time-to-event (all-cause mortality) by applying Cox models. 111,260 cancer patients from England were included in the analysis. Compared with antibiotic prescriptions that were issued in the past, patients who had been prescribed antibiotics shortly before cancer diagnosis presented an increased hazard ratio (HR) for mortality. For leukaemia, the HR in the Cancer Registry was 1.32 (95% CI 1.16-1.51), for lymphoma it was 1.22 (1.08-1.36), for melanoma it was 1.28 (1.10-1.49), and for myeloma it was 1.19 (1.04-1.36). Increased HRs were observed for cancer of the uterus, bladder, and breast and ovarian and colorectal cancer. Antibiotics that had been issued within the three months prior to cancer diagnosis may reduce the effectiveness of chemotherapy and immunotherapy. Judicious antibiotic prescribing is needed among cancer patients.
Sections du résumé
BACKGROUND
BACKGROUND
There is limited evidence in humans as to whether antibiotics impact the effectiveness of cancer treatments. Rodent studies have shown that disruption in gut microbiota due to antibiotics decreases cancer therapy effectiveness. We evaluated the associations between the antibiotic treatment of different time periods before cancer diagnoses and long-term mortality.
METHODS
METHODS
Using the Clinical Practice Research Datalink GOLD, linked to the Cancer Registry's and the Office for National Statistics' mortality records, we delineated a study cohort that involved cancer patients who were prescribed antibiotics 0-3 months; 3-24 months; or more than 24 months before cancer diagnosis. Patients' exposure to antibiotics was compared according to the recency of prescriptions and time-to-event (all-cause mortality) by applying Cox models.
RESULTS
RESULTS
111,260 cancer patients from England were included in the analysis. Compared with antibiotic prescriptions that were issued in the past, patients who had been prescribed antibiotics shortly before cancer diagnosis presented an increased hazard ratio (HR) for mortality. For leukaemia, the HR in the Cancer Registry was 1.32 (95% CI 1.16-1.51), for lymphoma it was 1.22 (1.08-1.36), for melanoma it was 1.28 (1.10-1.49), and for myeloma it was 1.19 (1.04-1.36). Increased HRs were observed for cancer of the uterus, bladder, and breast and ovarian and colorectal cancer.
CONCLUSIONS
CONCLUSIONS
Antibiotics that had been issued within the three months prior to cancer diagnosis may reduce the effectiveness of chemotherapy and immunotherapy. Judicious antibiotic prescribing is needed among cancer patients.
Identifiants
pubmed: 37754529
pii: curroncol30090614
doi: 10.3390/curroncol30090614
pmc: PMC10528751
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
8434-8443Subventions
Organisme : Connected Health Cities - Department of Health
ID : R119732
Références
Ther Adv Drug Saf. 2012 Apr;3(2):89-99
pubmed: 25083228
Nat Microbiol. 2018 Nov;3(11):1255-1265
pubmed: 30349083
Proc Natl Acad Sci U S A. 2011 Mar 15;108 Suppl 1:4554-61
pubmed: 20847294
Nat Rev Clin Oncol. 2018 Jun;15(6):382-396
pubmed: 29636538
Microorganisms. 2019 Jan 10;7(1):
pubmed: 30634578
Nature. 2015 Dec 10;528(7581):262-266
pubmed: 26633628
Nature. 2016 Jul 06;535(7610):65-74
pubmed: 27383981
Int J Mol Sci. 2023 Feb 04;24(4):
pubmed: 36834525
Science. 2018 Jan 5;359(6371):97-103
pubmed: 29097493
Diabetologia. 2017 Sep;60(9):1662-1667
pubmed: 28770326
Science. 2013 Nov 22;342(6161):971-6
pubmed: 24264990
Nat Rev Gastroenterol Hepatol. 2017 Jun;14(6):356-365
pubmed: 28270698
ISME J. 2016 Mar;10(3):707-20
pubmed: 26359913
Oncologist. 2020 Jan;25(1):55-63
pubmed: 31292268
Ann Oncol. 2019 Oct 1;30(10):1572-1579
pubmed: 31268133
Science. 2013 Nov 22;342(6161):967-70
pubmed: 24264989
Cancer Chemother Pharmacol. 2011 Jan;67(1):201-13
pubmed: 20354702
J Cancer. 2020 Jun 28;11(17):5135-5149
pubmed: 32742461
Sci Rep. 2020 Jan 23;10(1):1040
pubmed: 31974429
Mol Clin Oncol. 2015 Jan;3(1):3-12
pubmed: 25469262
Br J Gen Pract. 2013 Jan;63(606):e1-10
pubmed: 23336443
J Antimicrob Chemother. 2022 Apr 27;77(5):1218-1227
pubmed: 35211738
Gut. 2016 May;65(5):749-56
pubmed: 26719299
J Immunol. 2015 Feb 15;194(4):1983-95
pubmed: 25589072
Dig Liver Dis. 2015 Dec;47(12):1007-12
pubmed: 26257129
Int J Epidemiol. 2015 Jun;44(3):827-36
pubmed: 26050254
Clin Microbiol Infect. 2016 Feb;22(2):178.e1-178.e9
pubmed: 26482265
Gut. 2016 May;65(5):740-8
pubmed: 26657899
Sci Transl Med. 2015 Jan 21;7(271):271ps1
pubmed: 25609166
Nat Rev Cancer. 2017 May;17(5):271-285
pubmed: 28303904
JAMA Oncol. 2019 Dec 1;5(12):1774-1778
pubmed: 31513236
Sci Rep. 2015 Sep 29;5:14554
pubmed: 26416623
PLoS Biol. 2016 Aug 19;14(8):e1002533
pubmed: 27541692
Science. 2015 Nov 27;350(6264):1079-84
pubmed: 26541610
Science. 2018 Jan 5;359(6371):91-97
pubmed: 29097494