{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,13]],"date-time":"2025-06-13T08:09:16Z","timestamp":1749802156865,"version":"3.40.5"},"reference-count":36,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T00:00:00Z","timestamp":1705968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2024,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The health of the gut microbiome is now recognized to be an important component of the gut\u2013brain axis which itself appears to be implicated in pain perception. Antibiotics are known to create dysbiosis in the microbiome, so whether fibromyalgia is more commonly diagnosed after antibiotic prescriptions provides a means of exploring the role of the microbiome in the experience of chronic pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A case\u2013control study was carried out using electronic health records collected in the UK's Clinical Practice Research Datalink (CPRD), a comprehensive database of primary care consultations. For each case of diagnosed fibromyalgia, three controls were identified and matched by age, gender and GP practice. The exposure variable was the number and timing of antibiotic prescriptions over previous years. The analysis involved adjusting for a wide range of co\u2010variates that might be possible confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 44,674 cases of fibromyalgia were identified together with 133,513 controls. After adjusting for co\u2010variates, it was found that both the total number of prescriptions and their timing was associated with an FM diagnosis. For example, the quartile with the highest number of prescriptions and that with the longest exposure had a greater than three\u2010fold increase in FM diagnoses (number of prescriptions: odds ratio 3.92; 95% CIs: 3.71\u20134.13; exposure odds ratio 3.28; CIs: 3.13\u20133.43). Some antibiotics (such as tetracyclines and metronidazole) seemed to confer greater risk than others.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The results lend support for prior antibiotics being an important risk factor for a diagnosis of FM.<\/jats:p><\/jats:sec><jats:sec><jats:title>Significance<\/jats:title><jats:p>This study shows an association between the volume as well as timing of prior antibiotic prescriptions and of a subsequent diagnosis of fibromyalgia in primary care.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ejp.2239","type":"journal-article","created":{"date-parts":[[2024,1,23]],"date-time":"2024-01-23T16:09:09Z","timestamp":1706026149000},"page":"1008-1017","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Risk of fibromyalgia following antibiotic prescriptions: A\u00a0population\u2010based case\u2013control study"],"prefix":"10.1002","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3652-9662","authenticated-orcid":false,"given":"David","family":"Armstrong","sequence":"first","affiliation":[{"name":"Department of Population Health Sciences King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alex","family":"Dregan","sequence":"additional","affiliation":[{"name":"Department of Psychological Medicine Institute of Psychiatry, Psychological, and Neurosciences, King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark","family":"Ashworth","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"White","sequence":"additional","affiliation":[{"name":"Department of Population Health Sciences King's College London  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,1,23]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/microorganisms9112354"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00284-022-03124-9"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.3399\/bjgp16X684313"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynpai.2020.100059"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2021.105203"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynpai.2021.100072"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynpai.2021.100070"},{"key":"e_1_2_7_9_1","first-page":"S118","article-title":"Chronic widespread pain and fibromyalgia: Could there be some relationship with infections and vaccinations?","volume":"29","author":"Cassisi G.","year":"2011","journal-title":"Clinical and Experimental Rheumatology"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ebiom.2019.07.031"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2021.02.007"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm8101753"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/pds.3651"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2018-214676"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820977402"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-020-03201-9"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keaa847"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.13765"},{"key":"e_1_2_7_19_1","first-page":"1701","article-title":"Fibromyalgia and irritable bowel syndrome interaction: A possible role for gut microbiota and gut\u2010brain Axis","volume":"11","author":"Garofalo C.","year":"2023","journal-title":"Biomedicine"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2019.01.019"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pnpbp.2020.110078"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyv098"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-1253(17)30338-2"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.intimp.2023.109685"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000002694"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000001640"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000004204"},{"key":"e_1_2_7_28_1","first-page":"175","article-title":"Insulin resistance is associated with central pain in patients with fibromyalgia","volume":"24","author":"Pappolla M. 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