MANAGEMENT OF REACTIVE CHLAMYDOPHILA PNEUMONIA ASSOCIATED ARTHRITIS

Objective. Assess the articular syndrome and laboratory data dynamics in patients with reactive Chlamydophila pneumoniae associated arthritis on the background of complex anti-inflammatory and antibacterial therapy.

Materials and methods. The articular syndrome and laboratory data dynamics was evaluated in 30 patients with reactive Chlamydophila pneumoniae associated arthritis aged 18 to 68 years the disease average disease being 12 (6—24 months) months in 3 and 7 months after appointment of an antibacterial therapy course on the background of anti-inflammatory drugs administration. Chlamydophila pneumoniae infection was diagnosed using the following methods: the real-time PCR in the samples from the oral cavity, urethra, cervical canal, synovial fluid, the PCR of the isothermal amplification of nucleic acids in the synovial fluid as well as the detection of blood specific antibodies (IgM, IgA, IgG) by ELISA. The antibiotics, after identifying of Chlamydophila pneumoniae infection, were prescribed according to the recommendations developed for eradication of chlamydial (urogenic) infection in patients with reactive arthritis on the basis of the сlinical protocol for diagnosing and managing rheumatic diseases (adult population) by the Ministry of Health of the Republic of Belarus of 10.05.2012 №522. The data was processed using MS Excel and STATISTICA 10 (serial number BXXR207F383402FA-V).

Conclusion. Antibacterial and anti-inflammatory therapy in patients with reactive Chlamydophila pneumoniae associated arthritis allows achieve the disease remission in 40.0% of patients by the 3rd month of therapy. By the 7th month of the observation, the treatment effect has not increased. The disease remission has been observed in 46.1% of patients whereas in 53.8% of patients, the reactive arthritis has required a prolonged, chronic course, including those patients who have been re-prescribed antibacterial drugs (26.6%). It seems that the treatment of patients with reactive Chlamydophila pneumoniae associated arthritis should include a course of antibacterial therapy with macrolides, fluoroquinolones, doxycycline for the purpose of the infection eradication and anti-inflammatory therapy appointment. Basic anti-inflammatory drugs are prescribed in case of a chronic disease course, if medically required. The repeated antibiotics courses should be repeated by the doctor’s special decision and the course duration should be determined individually in each case.

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Автор(ы): S. V. Sharuba, N. F. Soroka