[Comparative effectiveness of antibacterial drugs in the treatment of reactive arthritis]

The authors have studied efficacy of various antibacterial drugs in reactive arthritis (RA). A comparative randomized trial was made of efficacy of doxocycline (DC) in a dose 200 mg/day, erythromycin (EM) in a dose 2 g/day, co-trimoxazole (CT) in a dose 1920 mg/day, cyprofloxacin (CF) in a dose 1 g/day in 79 RA patients. Each of the drug was given as two three-week courses with a 3-week interval. The patients were followed up for 12 months. The assessment of the drugs effect on the articular syndrome and the symptoms of the infectious focus was made with the use of computer questionnaire. 3-month remission was achieved in 9 DC patients (43%), 5 EM patients (24%), 6 CF patients (32%) and only in one CT patient (6%). Suppression of the infectious foci was similar for all the drugs tested during the follow-up period. Within the first three months of the trial DC had significant advantages over the other antibiotics in management of the articular syndrome. CF was highly effective (p < 0.001) in patients with RA running up to one year. The conclusion is made that suppression of the symptoms of the focal infection is not sufficient for RA effective treatment, antibiotics vary significantly by their effect on the course of the articular process.