Successful Treatment of Postvenereal Reactive Arthritis With Synovectomy and 3 Months’ Azithromycin

Pavlica, Ljiljana; Nikolić, Dragan; Magić, Zvonko; Brajušković, Goran; Strelić, Nataša J.; Miličić, Biljana; Jovelic, Aleksandra

doi:10.1097/01.rhu.0000182153.18181.81

Cited by 15 publications

(8 citation statements)

References 42 publications

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“…The conclusion presented is that prolonged treatment with azithromycin is ineffective in ReA. Recently, however, Pavlica et al observed that when a threemonth course of azithromycin was combined with synovectomy, the outcome was good [42].…”

Section: Long-term Antibiotic Treatment Of Es-tablished Reamentioning

confidence: 90%

Antibiotics in the Treatment of Reactive Arthritis

Toivanen¹,

Yli‐Kerttula

Möttönen

2006

CRR

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Reactive arthritis is triggered by an infection. Much of evidence has been accumulated to prove that the causative microbes or their components may persist in the organism for extended periods, maintaining an active immune response. Therefore, the question about the value of antibiotics has been entertained by several research groups. A number of studies have demonstrated that antibiotics may be useful only if applied very early, before the pathogenetic process has started. In established reactive arthritis short-term treatment is apparently not effective. Also a three-month course of ciprofloxacin has been demonstrated to be without clinical effect as observed during a one-year follow-up. The same findings were made in a large multicenter EULAR study regarding azithromycin. However, when patients were re-examined four to seven years after an initial 3-month course of the antibiotics in the Finnish ciprofloxacin study, it turned out that patients in the placebo group had significantly more often developed chronic joint symptoms and objective findings of rheumatic disease than those treated with the antibiotic. In addition, a recent study suggests that intensive treatment with a combination of doxycycline and rifampin may have a beneficial effect even in chronic reactive arthritis. The question must be raised whether antibiotics, after all, should be considered especially in HLA-B27 positive patients.

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Section: Long-term Antibiotic Treatment Of Es-tablished Reamentioning

confidence: 90%

Antibiotics in the Treatment of Reactive Arthritis

Toivanen¹,

Yli‐Kerttula

Möttönen

2006

CRR

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“…Considering an antibiotic therapy for ReA, it has been suggested that the period of treatment should last at least 3 months or even longer . Our previous report demonstrated the efficacy of parallel antibiotic (azithromycin) and surgical (arthroscopic synovectomy) treatment . In this study, we analysed the effects of synovectomy followed by a 4‐month course of antibiotics (ciprofloxacin, tetracycline and roxithromicin).…”

Section: Clinical Characteristics Of Patientsmentioning

confidence: 99%

“…9 Our previous report demonstrated the efficacy of parallel antibiotic (azithromycin) and surgical (arthroscopic synovectomy) treatment. 19 In this study, we analysed the effects of synovectomy followed by a 4-month course of antibiotics (ciprofloxacin, tetracycline and roxithromicin). The clinical remission was achieved in 15/22 patients after the therapy.…”

Section: Brief Communicationsmentioning

confidence: 99%

Detection of bacteria and analyses of Chlamydia trachomatis viability in patients with postvenereal reactive arthritis

Strelić

Bojovic

Pavlica

et al. 2014

Internal Medicine Journal

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Postvenereal reactive arthritis is an inflammatory form of arthritis that commonly develops after urogenital infection, predominantly in human leucocyte antigen-B27-positive men in the third decade of life. In our hospital, patients underwent synovectomy before a 4-month course of antibiotics (ciprofloxacin, tetracycline and roxithromicin). The clinical remission was achieved in approximately 70% patients. At molecular level, the remission was associated with the negative polymerase chain reaction findings of bacteria.

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“…Die Kombination der Antibiose mit chirurgischen Maßnahmen (Azithromycin und Synovektomie) erwies sich in Einzelfällen dagegen als erfolgreicher therapeutischer Ansatz [20]. …”

Section: » Primär Werden Doxycyclin Oder Azithromycin Empfohlenunclassified

Diagnostik und Therapie von Chlamydia-trachomatis-Infektionen

Meyer

2011

Hautarzt

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Nucleic acid amplification tests are now considered the method of choice to detect Chlamydia trachomatis. These assays have highest sensitivity and also high specificity, comparable to culture. First-void urine is the preferred specimen for urogenital infections of males, whereas vaginal and cervical swabs are at least as effective for testing female lower genital tract infections. Chlamydia point-of-care tests may produce results rapidly without special equipment but lack diagnostic accuracy and thus are unsuitable for routine use. Serology is not useful for detection of acute infections, but may help to identify persistent infections with Chlamydia no longer detectable in swabs or urine specimens. Various guidelines recommend doxycycline and azithromycin for treatment of uncomplicated Chlamydia infection. Alternatively erythromycin, ofloxacin and levofloxacin can be used. Persistent infections usually require treatment for longer periods or by using combinations of different antibiotics.

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Successful Treatment of Postvenereal Reactive Arthritis With Synovectomy and 3 Months’ Azithromycin

Cited by 15 publications

References 42 publications

Antibiotics in the Treatment of Reactive Arthritis

Antibiotics in the Treatment of Reactive Arthritis

Detection of bacteria and analyses of Chlamydia trachomatis viability in patients with postvenereal reactive arthritis

Diagnostik und Therapie von Chlamydia-trachomatis-Infektionen

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