prophylactic antibiotics and arthritis

[Guest guest]

So is having RA alone a risk factor requiring antibiotics in these

situations? Any thoughts? I remember how badly my arthritis flared with a

recent UTI and with the flu. Liz G.

from www.docguide.com

Susceptibility To Bacterial Arthritis Governs Need For Antibiotics In Joint

Patients

ls of the Rheumatic Diseases

05/03/2001

By Elda Hauschildt

A majority of patients with joint disease do not have characteristics that

increase their susceptibility to bacterial arthritis.

Antibiotic prophylaxis is thus recommended only when joint-disease patients

with increased susceptibility have dermal or urinary and respiratory tract

infections.

" Prophylaxis for invasive medical procedures, such as dental treatment, may

only be indicated for patients with joint disease who are highly

susceptible " to bacterial arthritis, researchers from the Netherlands

suggest.

Investigators from the Centre for Clinical Decision Sciences at Eramus

University in Rotterdam used data from a prospective study to assess the

effectiveness of antibiotic prophylaxis for hematogenous bacterial

arthritis.

They combined data on 4,907 patients with joint disease with literature data

to assess risks and benefits. They then looked at effectiveness and cost

effectiveness for various patient groups.

Patients were grouped by type of event leading to transient bacteremia and

by susceptibility to bacterial arthritis.

Types of events included dermal and respiratory/urinary tract infections and

invasive medical procedures. Susceptibility increases were based on the

presence of rheumatoid arthritis, large joint prostheses, comorbidity and

old age.

" Of patients with joint disease, 59 percent had no characteristic that

increased susceptibility to bacterial arthritis, and 31 percent had one, "

the researchers report.

They say that the effectiveness of antibiotic prophylaxis for dermal

infections was maximally 35 quality adjusted life days. For other

infections, prophylaxis effectiveness was lower.

" Prophylaxis for invasive medical procedures seemed to be acceptable only in

patients with high susceptibility, " investigators note.

ls of the Rheumatic Diseases, 2001; 60: 359-366.