Antibiotic Therapy: The Big Picture

This fall, a paper in the Journal of Rheumatology(1) appeared to advance the not-very-shocking thesis that tetracyclines are under-prescribed as a treatment for rheumatoid arthritis. A unique metaanalysis by four Toronto researchers reviewed selected randomized clinical trials comparing tetracyclines to controls that included not only placebos but conventional DMARDS.

"Conclusion: ... minocycline ... was associated with a clinically significant improvement in disease activity in RA with no absolute increased risk of side effects." The analysis also suggested that minocycline alone was somewhat more effective than when combined with doxycycline. "Further research is warranted," it concluded, "to compare these agents to newer disease modifying drugs for ... safety, efficacy, and cost effectiveness."

1. 2003; 30:2112-22 Should Tetracycline Treatment Be Used More Extensively for Rheumatoid Arthritis?