{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:58:55Z","timestamp":1760147935294,"version":"build-2065373602"},"reference-count":53,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T00:00:00Z","timestamp":1678838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Background: The susceptibility to SARS-CoV-2 infection is complex and not yet fully elucidated, being related to many variables; these include human microbiome and immune status, which are both affected for a long period by antibiotic use. We therefore aimed to examine the association of previous antibiotic consumption and SARS-CoV-2 infection in a large-scale population-based study with control of known confounders. Methods: A matched case\u2013control study was performed utilizing the electronic medical records of a large Health Maintenance Organization. Cases were subjects with confirmed SARS-CoV-2 infection (n = 31,260), matched individually (1:4 ratio) to controls without a positive SARS-CoV-2 test (n = 125,039). The possible association between previous antibiotic use and SARS-CoV-2 infection was determined by comparing antibiotic consumption in the previous 6 and 12 months between the cases and controls. For each antibiotic consumed we calculated the odds ratio (OR) for documented SARS-CoV-2 infection, 95% confidence interval (CI), and p-value using univariate and multivariate analyses. Results: The association between previous antibiotic consumption and SARS-CoV-2 infection was complex and bi-directional. In the multivariate analysis, phenoxymethylpenicillin was associated with increased rate of SARS-CoV-2 infection (OR 1.110, 95% CI: 1.036\u20131.191) while decreased rates were associated with previous consumption of trimethoprim-sulfonamides (OR 0.783, 95% CI: 0.632\u20130.971) and azithromycin (OR 0.882, 95% CI: 0.829\u20130.938). Fluroquinolones were associated with decreased rates (OR 0.923, 95% CI: 0.861\u20130.989) only in the univariate analysis. Previous consumption of other antibiotics had no significant association with SARS-CoV-2 infection. Conclusions: Previous consumption of certain antibiotic agents has an independent significant association with increased or decreased rates of SARS-CoV-2 infection. Plausible mechanisms, that should be further elucidated, are mainly antibiotic effects on the human microbiome and immune modulation.<\/jats:p>","DOI":"10.3390\/antibiotics12030587","type":"journal-article","created":{"date-parts":[[2023,3,15]],"date-time":"2023-03-15T05:53:44Z","timestamp":1678859624000},"page":"587","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Association between Previous Antibiotic Consumption and SARS-CoV-2 Infection: A Population-Based Case-Control Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Matan","family":"Dugot","sequence":"first","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 40700, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eugene","family":"Merzon","sequence":"additional","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 40700, Israel"},{"name":"Leumit Health Services, Tel Aviv 64738, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7244-0679","authenticated-orcid":false,"given":"Shai","family":"Ashkenazi","sequence":"additional","affiliation":[{"name":"Adelson School of Medicine, Ariel University, Ariel 40700, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shlomo","family":"Vinker","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel Aviv 64738, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9435-7152","authenticated-orcid":false,"given":"Ilan","family":"Green","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel Aviv 64738, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Avivit","family":"Golan-Cohen","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel Aviv 64738, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4389-8896","authenticated-orcid":false,"given":"Ariel","family":"Israel","sequence":"additional","affiliation":[{"name":"Leumit Health Services, Tel Aviv 64738, Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,15]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2023, February 04). 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