Effect of a three month course of ciprofloxacin on the outcome of reactivearthritis

Background-Treatment of reactive arthritis (ReA) with antibiotics has so fa r remained controversial. Eradication of the causative microbe appears logi cal, but short term antibiotic treatment has no beneficial effect on the ou tcome of ReA. Objective-To evaluate the effect of a three month course of ciprofloxacin o n ReA. Methods-In a randomised, double blind, placebo controlled trial, between De cember 1992 and February 1996, 71 patients with acute ReA triggered by a ga strointestinal or a urogenital infection were randomly assigned to receive ciprofloxacin 500 mg or placebo twice daily for three months. Patients were assessed at study entry, at 6 weeks, 3 months, 6 months, and 12 months. Si xty two patients were valid for the efficacy analysis. The primary outcome measures were erythrocyte sedimentation rate, number of swollen joints, pat ients self assessment, and complete recovery. Results-Adverse events were mostly mild and occurred in both treatment grou ps. There were no statistically significant differences in any of the prima ry or secondary efficacy variables between the study groups at baseline or during the 12 month follow up. All primary outcome measures indicated that the condition of the patients improved during the study. Conclusion-Both groups tended to recover. Ciprofloxacin, given as a three m onth course, had no advantage over placebo treatment.