Description

Some antibiotics can affect uric acid levels and potentially trigger gout attacks through various mechanisms. Certain antibiotics, particularly those in the penicillin family, can compete with uric acid for renal tubular excretion, leading to increased serum uric acid levels. Additionally, some antibiotics may cause rapid cell death of bacteria, releasing purines into the bloodstream and potentially overwhelming the body's ability to excrete uric acid efficiently. The risk is generally higher with intravenous antibiotics and in patients with pre-existing risk factors for gout. It's important to note that while antibiotics can trigger gout in susceptible individuals, this side effect is relatively rare and should not deter necessary antibiotic treatment. A retrospective cohort study published in the Annals of the Rheumatic Diseases found that the use of certain antibiotics, especially clarithromycin, was associated with an increased risk of gout flares [1]. Another study in the Journal of Rheumatology demonstrated that antibiotic-induced gout was more common in patients with a history of gout or hyperuricemia [2]. Healthcare providers should be aware of this potential side effect and monitor patients at risk for gout when prescribing these antibiotics.