Prolonged Antibiotic Combo May Help Cure Reactive Arthritis

A combination of antibiotics effectively treats Chlamydia-induced reactive arthritis, according to results of a study conducted by researchers from the University Of South Florida College Of Medicine.

The findings were printed in the May issue of Arthritis & Rheumatism. Researchers designed the study in an effort to investigate the effectiveness of a six-month course of combination antibiotics. The combinations of antibiotics used included rifampin, which interferes with chlamydial gene transcription, and doxycycline or azithromycin, which block chlamydial protein synthesis.

Rifampin has proven itself effective in tissue penetration and is often used in the treatment of Chlamydial-induced ReA. However, long-term use of the treatment has been deemed controversial, according to some studies.

Lead study researcher J.D. Carter, M.D., said the team focused on the two combinations because of their specific effects on the Chlamydia bacteria, according to a press release.

“"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,” Carter said, in a press release. “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 prospective, double-blind study took place within a span of nine months; 42 subjects were enrolled and randomized. Researchers found that “a six-month course of combination antibiotics resulted in a significantly higher response rate in patients with chronic Chlaymdia-induced ReA.”

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