Article Text

Download PDFPDF
Antimicrobial treatment for Chlamydia induced reactive arthritis
  1. J D Carter1,
  2. J Valeriano1,
  3. F B Vasey1
  1. 1University of South Florida, Division of Rheumatology, 12901 Bruce B Downs Blvd, MDC 81 Tampa, FL 33612, USA
  1. Correspondence to:
    Dr J D Carter
    jocarterhsc.usf.edu

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

We read with interest the article entitled “Three month treatment of reactive arthritis with azithromycin: a EULAR double blind, placebo controlled study”.1 The trial of Kvien et al suggests that weekly administration of azithromycin for 3 months is not efficacious in ameliorating the symptoms of reactive arthritis (ReA). Although this point seems clear, the authors then make a leap of faith and suggest that “this study does not support the prolonged use of antibiotics for the alleviation of ReA”. There are several problems with this generalisation.

As Kvien et al correctly point out, polymerase chain reaction technology has documented the presence of Chlamydia and other causative organisms in the synovial tissue of patients with ReA.2 This same technology has convincingly shown both in vitro and in vivo evidence of persistent metabolically active Chlamydia.2 The data on post-dysentery organisms have repeatedly demonstrated bacterial fragments,3 but viability has only been suggested in the case of Yersinia.4 This makes a strong argument for the use of antimicrobial agents in post-chlamydial ReA, yet both patients with post-venereal and post-dysentery ReA were included in this trial.

Previous therapeutic trials also …

View Full Text