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Combination antibiotics effective against chlamydia-induced arthritis
Date:4/28/2010

fter the initial infection. That begged the question: could antibiotics treat Chlamydia-induced ReA? Previous clinical trials with single antibiotics were negative or failed to demonstrate any definitive effect.

A nine-month study by Dr. Carter and colleagues, published in 2004 in the Journal of Rheumatology, was the first to compare combination antibiotic therapy (doxycycline and rifampin) with monotherapy (doxycycline only). It showed a dramatic response to the combination in patients with Chlamydia-induced arthritis.

Based on these promising early results, the USF-led research team devised a new prolonged course of combination antibiotic treatment, which attacked two different pathways allowing Chlamydia infection to persist in the joints.

In the latest double-blind, placebo-controlled multicenter trial, 42 patients were randomly assigned to one of three treatment groups -- rifampin plus doxycycline, rifampin plus azithromycin, or placebo. All the patients tested positive for Chlamydia trachomatis or Chlamydia pneumoniae. They received combination antibiotics or placebo for six months and were followed for three months post-treatment.

Patients treated with the combination antibiotics improved significantly more in measures of the swelling and tenderness of joints and symptom assessment. In fact, the researchers report, 22 percent of patients receiving combination antibiotics experienced complete remission of ReA, while none in the placebo group did. Significantly more patients receiving combination antibiotics tested negative for Chlamydia bacteria in their blood or joint tissue following treatment. Adverse side effects, mostly gastrointestinal, were mild.

In an editorial appearing in the same issue as the USF-led study, Dr. Markus Rihl of Hannover Medical School in Germany writes, "the positive results using combination antibiotics are very promising to open a new way of treatment not only for Chlamydia-induced
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Contact: Anne DeLotto Baier
abaier@health.usf.edu
813-974-3300
University of South Florida Health
Source:Eurekalert  

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