Question
Do you recommend Antibiotic Therapy for RA? I am currently on Remicade infusions every 6 wks and 15mg of Methotrexate a week, & 2.5mg of Prednisone, 400mg of Plaqunil a day. I am beginning to feel relief from the infusions (I have had 4 total) but I am still very tired and I keep getting sore throats….not sure why. I can walk much better than I was able to walk a few months ago. Do you think I should explore the Antibiotic therapy or just stick with what I am currently doing and possibly be able to get off of some the my current medications in the near furture?
Answer
Unless you have a suspected bacterial infection, there is no role for antibiotics in the treatment for RA. This has been looked at extensively over the years. The NIH did a large study looking at both aggressive antibiotic treatments and looking for infection within swollen joints using PCR. There was no evidence for infection. Antibiotics minocycline and doxycycline have been looked at in many controlled trials. There may be a slight benefit from long term use of these antibiotics, but certainly these therapies do not rival the newer biologic treatments.
