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Antibiotic regimen effective for reactive arthritis
Date:4/28/2010

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 o
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Contact: Dawn Peters
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