AZITHROMYCIN THERAPY IN ARTHRITIS ASSOCIATED WITH PREVIOUS INFECTION

Background: Isolation of Chlamydia and other bacteria, demonstration of their nucleic acids by PCR as well as particles and antigens by immuno-electron microscopy in synovial fluid and synovium of patients with reactive artrhritis, suggest that antibiotic therapy might be a curative treatment for many of these patients.Objectives: This prospective study was designed to evaluate the prolonged azthromycin therapy in patients with arthritis associated with previous infection. We also wanted to evaluate the patients' tolerance to this antibiotic regimen.Methods: Within the period May 2001.- November 2002. 22 patients (16 males and 6 females) with arthritis (14 monoarthritis, 6 oligoarthritis, 2 polyarthritis) were examined and treated. One patient was excluded from the study within the first week of the study due to gastrointestinal distress. Average age of patients was 38.6 years (15-68 years), disease duration before treatment was in average. It had been recurrent in. A special follow-up protocol was used for these patients. Presence of bacteria was demonstrated by their isolation and PCR methods. Azithromycin was administered in doses of500mg/day for 5 days and than 500mg biw for 3 months. Therapy effects were evaluated by laboratory findings, visual analog scales of both physicians and patients' evaluation and physicial examination.Results: Bacterial identification results are presented in Table 1. After the study 15(68.2%) patients were in remission. After one-month treatment period elevated transaminases were found in 2 patients. Antibiotic therapy was discontinued for one month and continued two months more. A transient elevatedK level was found in 1 patient and bilirubin level in 2. At the end of the study all followed-up parameters were normal. C. trachomatis C. pneumoniae T-mycoplasma synovial fluid 2 *6(MH5+UU3) synovium 1 1 urogen. syst. *9(MH1+UU9) * Both Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) were isolated oth Mycoplasma hominis (MH) and Ureaplasma urealyticum (UU) were isolatedConclusion: Three-month azithromycin therapy proved to be effective in 68.2% patients with arthritis associated with previous infection. It was an open study and so we could not exclude spontaneous improvement. Drug tolerance was satisfactory taking into account that all side effects were of transitory character.Citation: , volume , supplement , year 2003, page Session: Spondylarthropathies including psoriatic arthritis