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No, I don’t think so. In particular, for rheumatoid arthritis (RA) there is a long history suggesting that antibiotics appear to be effective (1).

A. Sulphonamides like sulfasalazine were used against RA in the 1930s and 1940s, and showed some effectiveness (2, 3). This treatment later evolved into the so-called triple DMARD therapy (combination of sulfasalazine, hydroxychloroquine and methotrexate) for treating RA (4, 5).

B. In the 1970s, McPherson Brown revived the long-held view that RA was triggered by an infection and suggested long-term antibiotics, particularly tetracycline (6) for RA treatment. Tetracyclines are protein synthesis inhibitors with broad spectrum antibiotic action. More recently, minocycline, a new generation tetracycline, was shown to be efficacious against RA in 4 different clinical trials (7, 8, 9, 10).

C. Macrolides are another class of antibiotic, also protein synthesis inhibitors. Macrolides like clarithromycin (11, 12, 13) and roxithromycin (14, 15) have also shown effectiveness in treating RA.

D. Fluoquinolones are another class of antibiotic which inhibit cell division by inhibiting enzymes such as DNA gyrase. Levofloxacin, a fluoroquinolone, has also been shown in at least one study (16) to be effective against RA.

Currently, one of the most intensively investigated hypotheses to understand RA etiology (cause) suggests that there is a causative link between periodontal disease and RA (17, 18, 19, 20, 21, 22, 23, 24). Periodontal disease is triggered by infection leading to inflammation of the periodontium, and it can lead to tooth loss. Porphyromonas gingivalis, Prevotella intermedia and Tannerella forsythia are among the bacteria most commonly associated with periodontal disease.

The history for an infectious disease origin for RA is quite long standing. In fact, William Osler, a man commonly described as ” the father of modern medicine”, first proposed an infectious disease origin for RA as far back as 1909.

1. Antibiotics for the treatment of rheumatoid arthritis
2. The treatment of rheumatic polyarthritis with aci… [Rheumatism. 1948]
3. Sulfasalazine in early rheumatoid arthritis. A 48-week double-blind, prospective, placebo-controlled study
4. Treatment of Rheumatoid Arthritis with Methotrexate Alone, Sulfasalazine and Hydroxychloroquine, or a Combination of All Three Medications — NEJM
5. Arthritis Care & Research
6. A mechanistic approach to treatment of rheumatoid type arthritis naturally occurring in a gorilla.
7. Treatment of early seropositive rheumatoid arthritis: A two-year, double-blind comparison of minocycline and hydroxychloroquine
8. Treatment of early Rheumatoid Arthritis with minocycline or placebo. Results of a Randomized, double-blind, placebo-controlled trial
9. Minocycline in Rheumatoid Arthritis: A 48-Week, Double-Blind, Placebo-Controlled Trial
10. Minocycline in active rheumatoid arthritis
11. Current Medical Research and Opinion
12. Europe PubMed Central
13. Clarithromycin in rheumatoid arthritis: the addition to methotrexate and low-dose methylprednisolone induces a significant additive value-a 24-month single-blind pilot study – Springer
14. Elsevier
15. Treatment of Rheumatoid Arthritis with Roxithromycin:
16. Levofloxacin Treatment in Patients with Rheumatoid Arthritis… : Southern Medical Journal
17. Page on apps.elsevier.es
18. The Role of the Microbiome in Rheumatic Diseases
19. Rheumatoid arthritis is an autoimmune disease caused by periodontal pa
20. Page on nih.gov
21. Elsevier: Article Locator
22. Page on landesbioscience.com
23. Do Bugs Control Our Fate? The Influence of the Microbiome on Autoimmunity
24. Page on nature.com

Does the use of high dose antibiotics cause auto immune diseases like rheumatoid arthritis?

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