A possible explanation for this finding includes alterations in the microbiome, especially effects on oxalate-degrading bacteria like O. Recent evidence suggests a possible, causal role of antibiotics in the development of kidney stones. The effect was greatest for those exposed at younger ages and 3-6 months before being diagnosed with nephrolithiasis. In a case-control study, exposure to sulfa drugs, cephalosporins, fluoroquinolones, nitrofurantoin/methenamine, and broad spectrum penicillins prospectively increased the odds of nephrolithiasis. A recent study showed that antibiotics can eliminate colonization with O. It also appears capable of stimulating colonic oxalate secretion. As a degrader of fecal oxalate its presence is associated with lower urinary oxalate, which would be protective against calcium oxalate stone formation. Studies of the intestinal microbiome have focused on Oxalobacter formigenes, an anaerobe that frequently colonizes the human colon. Here we review the evidence for exposure to antibiotics increasing the risk of nephrolithiasis. Recent evidence suggests a possible, causal role of antibiotics in the development of kidney stones. The effect of the intestinal microbiome on urine chemistry and lithogenicity has been a popular topic.
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