Navigation Links
Antibiotic regimen effective for reactive arthritis

Researchers from University of South Florida College of Medicine found a combination of antibiotics to be an effective treatment for Chlamydia-induced reactive arthritis, a major step forward in the management, and possibly cure, of this disease. Results of this study are published in the May issue of Arthritis & Rheumatism, a journal of the American College of Rheumatology.

Reactive arthritis (ReA), also known as Reiter's syndrome, occurs in response to an infection. According to National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the bacterium most often associated with ReA is Chlamydia trachomatis. Respiratory infections with Chlamydia pneumoniae can also trigger ReA, while associated infections in the digestive tract include Salmonella, Shigella, Yersinia, and Campylobacter. ReA symptoms usually last 3 to 12 months, although symptoms can return or develop into a long-term disease. In the past it was thought that only a small percentage of people would experience chronic symptoms of ReA. However, more recent data suggests that as many as 30%-50% of patients could develop a chronic form of the disease. In chronic ReA, symptoms can be severe and difficult to control with treatment, which could lead to joint damage.

The use of long-term antibiotic treatment for patients with ReA is controversial. Several reported studies have indicated that prolonged antimicrobial monotherapy is not efficacious, while other studies suggest there might be a benefit, specifically with early-stage Chlamydia-induced ReA.

The study led by J.D. Carter, M.D., focused on combinations including 2 antibiotics found to have specific effects on the Chlamydia bacteria. The first, rifampin, has excellent tissue penetration, an important weapon against intracellular pathogens such as Chlamydia. Rifampin also has been shown to interfere with chlamydial gene transcription, including the heat-shock proteins (HSPs), which can ultimately lead to the demise of the infected cell. Dr. Carter explains why this is important. "Combining this effect with antibiotics that block chlamydial protein synthesis (e.g., doxycycline or azithromycin) may allow for successful eradication of the cell harboring persistently infecting intracellular organisms. A recent pilot study conducted by our group suggested that prolonged treatment with a combination of doxycycline and rifampin significantly improves symptoms of chronic undifferentiated spondylarthritis (SpA) (with a special focus on Chlamydia) compared with doxycycline alone. The goal of the present study was to further investigate whether a 6-month course of combination antibiotics, one of which is rifampin, is effective in the treatment of patients with chronic Chlamydia-induced ReA."

The 9-month, prospective, double-blind, triple-placebo trial screened a total of 80 subjects, and 42 were enrolled and randomized to treatment. Twelve subjects were randomized to doxycycline and rifampin, 15 were randomized to azithromycin and rifampin, and 15 were randomized to matching oral placebos. The primary end pointan improvement of 20% or morewas achieved in 17 of 27 patients (63%) receiving combination antibiotics and in 3 of 15 patients (20%) receiving placebo. Secondary efficacy end points showed similar results, demonstrating that compared with placebo, a 6-month course of combination antibiotics resulted in a significantly higher response rate in patients with chronic Chlamydia-induced ReA, although which combination of antibiotics was most effective remained undetermined as the trial wasn't powered to compare the 2 regimens.

Dr. Carter concludes, "The results of this study are encouraging for the management of chronic post-Chlamydia ReA. These data suggest that there is potential for eradication of this persistent infection and that improvement in the clinical sequelae that are the result of these infections can be achieved in a substantial number of patients."

In an Editorial published in this month's issue, Dr. Henning Zeidler agrees. "The study by Carter et al shows impressive effects and, with them, the potential for the eradication of Chlamydia, which would cure Chlamydia-induced ReA."


Contact: Dawn Peters

Related medicine news :

1. Reportlinker Adds Antibiotic Resistance and Antibiotic Technologies: Global Markets
2. Soil studies reveal rise in antibiotic resistance
3. Disinfectant Misuse Might Help Germs Resist Antibiotics
4. Giant Eagle Pharmacy Free Antibiotics Program Surpasses $3 Million in Free Prescriptions
5. Poll: Hypothetical anthrax attack and antibiotics
6. Chitosan as alternative to growth-promoting antibiotics for ruminants
7. Penicillin Allergy Might Not Include Related Antibiotic
8. Hard to Treat Diseases (HTDS) Awarded Two Antibiotics Certificates For Chile
9. ID physicians call for 10 new antibiotics by 2020
10. Misinformation About Antibiotics Can Travel to Large Audience Via Twitter: Study
11. Misinformation about antibiotics can travel to large audience via Twitter: study
Post Your Comments:
(Date:6/27/2016)... ... June 27, 2016 , ... TherapySites, ... its affiliation with Tennessee Counseling Association. This new relationship allows TherapySites ... Tennessee Counseling Association, adding exclusive benefits and promotional offers. , "TCA is extremely ...
(Date:6/26/2016)... , ... June 27, 2016 , ... Quality metrics are ... in many ways they remain in the eye of the beholder, according to experts ... publication of The American Journal of Managed Care. For the full issue, click ...
(Date:6/26/2016)... ... , ... Brent Kasmer, a legally blind and certified personal trainer is helping to develop a ... fitness app plans to fix the two major problems leading the fitness industry today:, ... type program , They don’t eliminate all the reasons people quit their exercise ...
(Date:6/25/2016)... ... ... closing of Bruton Memorial Library on June 21 due to a possible lice infestation, as ... of head lice: the parasite’s ability to live away from a human host, and to ... one in the event that lice have simply gotten out of control. , As lice ...
(Date:6/25/2016)... Oklahoma (PRWEB) , ... June 25, 2016 , ... ... both athletes and non-athletes recover from injury. Recently, he has implemented orthobiologic procedures ... Oklahoma City area —Johnson is one of the first doctors to perform the ...
Breaking Medicine News(10 mins):
(Date:6/23/2016)... , June 23, 2016 , ... on Thursday, July 7, 2016 , , , , LOCATION: ... , , , , EXPERT PANELISTS:  , , , ... Senior Industry Analyst, Christi Bird; Senior Industry Analyst, Divyaa Ravishankar and ... The global pharmaceutical industry is witnessing an exceptional era. ...
(Date:6/23/2016)... and BOGOTA, Colombia , June 23, 2016  Astellas today announced the establishment of Astellas Farma ... as the company,s second affiliate in Latin America . ... ... Astellas Farma Colombia ... ...
(Date:6/23/2016)... 23, 2016  Guerbet announced today that it has ... Horizon Award . One of 12 suppliers ... for its support of Premier members through exceptional local ... and commitment to lower costs. ... of our outstanding customer service from Premier," says ...
Breaking Medicine Technology: