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Do Antibiotics Raise the Risk of Rheumatoid Arthritis

According to the Rheumatoid Arthritis Support Network (RASN), more than 1.3 million Americans are affected with Rheumatoid Arthritis (RA). They also report that women are up to three times more likely to be diagnosed with RA than men, and may also encounter it at an earlier age. Genetics, environment, and lifestyle have often been associated with a higher-than-average risk of rheumatoid arthritis; however, emerging research shows that antibiotic use may play a role as well. What is the connection between antibiotics and rheumatoid arthritis? Here’s what you need to know.

What is Rheumatoid Arthritis?

Rheumatoid arthritis, also known as RA, is an autoimmune condition in which the body attacks the synovial fluid found in the joints. This can lead to chronic inflammation, pain, and stiffness in one or more joints. More serious cases of rheumatoid arthritis can lead to numbness, red skin, shoulder pain, and difficulty breathing. Claw toes and bunions may also appear on the feet, making it difficult for you to walk or maintain your balance.

Those with rheumatoid arthritis may first begin noticing symptoms when they are in their 30s. Even so, it most often affects those age 60 and over. Some children may experience RA as well, although the condition is not all that common among juveniles.

Results of a UK Study

Emerging research shows there may be a connection between antibiotic use and rheumatoid arthritis. According to a UK study published in the journal BMC Medicine, antibiotics have a profound effect on gut health. In turn, gut health can lead to an increased risk of autoimmune disorders in general, including rheumatoid arthritis.

In reaching their conclusion, researchers from the Quadram Institute’s Norwich Research Park studied more 22,677 RA patients who had been diagnosed between 1990 and 2017. Those subjects were then compared to more than 90,000 people in a healthy control group who had not been diagnosed with rheumatoid arthritis. In doing so, they made a remarkable discovery: that the odds of someone developing rheumatoid arthritis was approximately 60% higher for those who had taken antibiotics.

The risk increased when people received multiple rounds of antibiotics. For example, those who only had one prescription had 40% greater odds, but individuals who had two rounds were at a 66% greater risk. Participants who had three or four courses of antibiotics had an even greater chance of developing RA.

The Effects of Time

This survey showed that antibiotics can play a role in the development of rheumatoid arthritis for many years after someone has taken them. Those who had taken antibiotics in the recent past (which for research purposes was considered one to two years) had an 80% greater risk of developing RA. At the same time, patients who had used them as far back as five to ten years ago still had a 48% higher chance of developing the condition that someone who had never taken antibiotics.

Type of Infection Matters

The type of infection people were treated for affected their odds of developing RA as well. Study results showed that rheumatoid arthritis was more prominent in individuals who took antibiotics for Upper Respiratory Infections or URIs. On the other hand, those who did not use antibiotics to treat their upper respiratory infections did not have a higher risk of developing RA. As a result, researchers concluded that using antibiotics to treat URIs would greatly increase a person’s chances of contracting RA.

Study Conclusion

As a result of the study, researchers concluded that “antibiotic prescriptions are associated with a higher risk of RA.” They also noted that “this may be due to microbiota disturbances or underlying infections driving risk.” Professor Christian Mallen of Keele Univeristy claimed that “this exciting work offers another glimpse into the complexity of understanding rheumatoid arthritis”, and mentioned that doors for continuing research had been opened because of it.

Advice for Patients

The latest research into the connection between antibiotics and rheumatoid arthritis may provide hope for anyone whose genetics and lifestyle predispose them to contracting it. Study results show that antibiotics may affect gut microbiota, which in turn can leave people more likely to develop autoimmune disorders such as RA. Accordingly, those who limit their use of antibiotics may be able to prevent this painful condition in the future. Likewise, those who have already been diagnosed with RA could experience fewer flare-ups by reducing their use of antibiotics as well.

Antibiotics and Rheumatoid Arthritis

In recent years, physicians have increasingly cautioned against the overuse of antibiotics. Thanks to this study, they now have another reason to forego prescribing antibiotics unless they are absolutely necessary. Those who must rely on them should be mindful of their possible effects on the gut, and take proactive measures to restore microbiota once they have finished their medications. By maintaining a healthy weight, staying active, and taking antibiotics only when necessary, it may be possible to reduce your risk of developing RA.


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The content on this page is for informational and educational purposes only and does not constitute professional medical advice. Patients should not use the information presented on this page for diagnosing a health-related issue or disease. Before taking any medication or supplements, patients should always consult a physician or qualified healthcare professional for medical advice or information about whether a drug is safe, appropriate or effective.