Objective. Antibiotic use is one of the strongest environmental predictors of an altered and less diverse gut microbiome, which has been linked to Parkinson’s disease. To our knowledge, no prior study has examined the association between long-term antibiotic use and Parkinson’s disease. Design. We conducted a prospective study of 59,637 women in the Nurses’ Health Study who reported total duration of antibiotic use at ages 20–39, 40–59, 60 +, or during the past 4 years. We used Cox Proportional Hazard regression to estimate hazard ratios and 95% confidence intervals for the association between categories of antibiotic use and risk of PD. Results. One hundred and eighty cases of PD were confirmed during the follow-up. Self-reported antibiotic use at ages 20–39, 40–59, and 60 +, as assessed in 2004, was not significantly associated with PD risk in our cohort. The hazard ratio comparing participants who used antibiotics for 2 or more months vs. 1–14 days at age 20–39 was 0.98 (95% CI: 0.54, 1.78), at age 40–59 was 1.44 (95% CI: 0.88, 2.33), and at age 60 +was 0.88 (95% CI: 0.53, 1.47). Antibiotic use during the past four years, as assessed in 2008, was also not associated with future risk of PD (HR: 1.14, 95% CI: 0.62, 2.10). Conclusion. In this cohort study, we did not observe a significant association between antibiotic use and incidence PD. A major limitation of our study is assessment of exposure, which required many participants to recall their antibiotic use decades in the past. Thus, although the results of this study do not support an effect of antibiotic use on PD risk, larger investigations relying on records of antibiotic prescriptions would provide more definitive evidence.

中文翻译：

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护士健康研究中长期使用抗生素和帕金森病风险。

客观。抗生素的使用是肠道微生物群改变和多样性降低的最强环境预测因子之一，这与帕金森病有关。据我们所知，之前没有研究检查过长期使用抗生素与帕金森病之间的关系。设计。我们对护士健康研究中的 59,637 名女性进行了一项前瞻性研究，她们报告了 20-39 岁、40-59 岁、60 岁以上或过去 4 年抗生素使用的总持续时间。我们使用 Cox 比例风险回归来估计抗生素使用类别与 PD 风险之间关联的风险比和 95% 置信区间。结果. 随访期间确诊180例PD。2004 年评估的 20-39、40-59 和 60+ 岁时自我报告的抗生素使用与我们队列中的 PD 风险没有显着相关性。比较在 20-39 岁时使用抗生素 2 个月或更长时间与 1-14 天的参与者的风险比为 0.98（95% CI：0.54，1.78），在 40-59 岁时为 1.44（95% CI：0.88， 2.33)，在 60 岁时为 0.88 (95% CI: 0.53, 1.47)。根据 2008 年的评估，过去四年的抗生素使用与未来 PD 风险无关（HR：1.14，95% CI：0.62，2.10）。结论. 在这项队列研究中，我们没有观察到抗生素使用与 PD 发病率之间存在显着关联。我们研究的一个主要限制是评估暴露，这需要许多参与者回忆过去几十年他们使用抗生素的情况。因此，尽管本研究的结果不支持抗生素使用对 PD 风险的影响，但依赖抗生素处方记录的更大规模调查将提供更明确的证据。