Reactive arthritis is like any autoimmune arthritis, a chronic destructive and frustrating disease to manage.This presumably develops following infections of the genitourinary and lower gastro intestinal mucosal surfaces. The uniqueness of this arthritis is there’s a gap between infection and the onset of arthritis and culturing or detecting the intact organism is very unusual.The arthritis is different from rheumatoid arthritis in that it involves the lower limb joints and spine more often.
The arthritis is usually treated with drugs suppressing the immune system while favourably affecting the arthritis joint resulting in less joint swelling , pain and bony destruction.
A new study by,Carter et al http://dx.doi.org/10.1002/art.27394,
paves way for a fresh look at the infectious versus autoimmune views of this poorly understood arthritis.The conclusion of the study boldly states that a 6 month course of antibiotics(rifampin and tetracycline/azithromycin) can treat patients with reactive arthritis.
I see two possible interpretations for the results. One is the anti-infective, that is the antibiotics cleared the Chlamydial antigens, reduced inflammation and improved symptoms. The other view is the immunomodulation provided by the antibiotics used in this study which favourably tilted the balance towards less inflammation.
So chronic antibiotic use help suppress an autoimmune disease process.