THE INFLUENCE OF ADDING ANTIBIOTIC IN TREATMENT OF RHEUMATOID ARTHRITIS PATIENTS ON STREPTOCOCCUS PYOGENES CARRIER RATE AND ON THE LIPIDS PROFILE

Objective: The main goal is to evaluate the clinical efficacy, safety, and tolerability of antibiotics and methotrexate (MTX) treatment on the disease severity, on Streptococcus pyogenes carrier rate and on the lipid profile of patients with rheumatoid arthritis (RA). Methods: In a 6-months, double –blind trial, 130 patients with active RA were treated for four weeks with MTX therapy at a stable low dose of 12.5 mg/week instructed to receive either levofloxacin (500 mg) or placebo orally once daily while continuing to receive MTX. Before and after the treatment, disease activity parameters, rheumatoid factor (CF), C reactive protein (CRP), anti-streptolysin O (ASO) titer and lipid profile were measured. Throat swab cultures were done on suitable medium. Results: Antibiotic adds to treatment causes a significant reduction in disease activity, lower the side effects and concomitant decrease in MTX treatment dose, most of the lipid levels had returned to baseline levels, decreased S. pyogenes carrier rate from 25-30% to 3.2-6% and lower ASO titers to undetectable. Conclusion: RA patients who are treated with MTX, addition of antibiotics lower the signs, symptoms and risk factors of RA patient and S. pyogenes could be important in the etiopathogenesis of RA.Â