Antibiotic Use Associated with Higher Risk of Kidney Stones | JASN

Key Points

  • Antibiotic exposure was associated with increased likelihood of  nephrolithiasis
  • Strongest correlation observed w/ sulfa antibiotics (+133% risk)
  • Weakest correlation observed w/ broad-spectrum penicillins (+27% risk)
  • Young age, recent antibiotic use (3-6 months before kidney stone) had the highest risk increase
  • Increased risk lasted at least 3-5 years, except for broad-spectrum penicillins


  • 70% increase in nephrolithiasis in past 30 years, largest increase in children and young women
  • Known association between antibiotic exposure and inflammatory bowel disease and asthma
  • Drug-resistant bacteria have been isolated from kidney stones (even in absence of urinary tract infection)
  • 30% of outpatient antibiotic prescriptions estimated to be inappropriate


  • Observational
  • Nested Case-Control
  • 25,981 patients w/ kidney stones
  • 259,797 control
  • Looked at antibiotic use 3-12 months before kidney stone


Source: Oral Antibiotic Exposure and Kidney Stone Disease