Abstract | OBJECTIVE: The aim of this study was to assess the clinical effect of antibiotic treatment in a cohort of patients with low-back pain (LBP) and Modic changes Type 1 (bone oedema) following a lumbar herniated disc. DESIGN: This was a prospective uncontrolled trial of 32 LBP patients who had Modic changes and were treated with Amoxicillin- clavulanate (500 mg/125 mg) 3 x day for 90 days. All patients had previously participated in a randomised controlled trial (RCT) that investigated active conservative treatment for a lumbar herniated disc (n = 166). All patients in that RCT who had Modic changes and LBP at 14 months follow-up (n = 37) were invited to participate in this subsequent antibiotic trial but five did not meet the inclusion criteria. RESULTS: 29 patients completed the treatment, as three patients dropped out due to severe diarrhoea. At the end of treatment and at long-term follow-up (mean 10.8 months) there was both clinically important and statistically significant (p<or=0.001) improvement in all outcome measures: LBP intensity, number of days with pain, disease-specific and patient-specific function, and global perceived effect. CONCLUSIONS: In this uncontrolled trial, the clinical effect of antibiotic treatment was large in a group of patients with Modic changes suffering from persistent LBP following a disc herniation. These results provide tentative support for a hypothesis that bacterial infection may play a role in LBP with Modic changes and indicate the need for randomised controlled trials to test this hypothesis.
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Authors | H B Albert, C Manniche, J S Sorensen, B W Deleuran |
Journal | British journal of sports medicine
(Br J Sports Med)
Vol. 42
Issue 12
Pg. 969-73
(Dec 2008)
ISSN: 1473-0480 [Electronic] England |
PMID | 18718972
(Publication Type: Journal Article)
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Chemical References |
- Anti-Bacterial Agents
- Amoxicillin-Potassium Clavulanate Combination
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Topics |
- Amoxicillin-Potassium Clavulanate Combination
(therapeutic use)
- Anti-Bacterial Agents
(therapeutic use)
- Bacterial Infections
(complications, drug therapy)
- Bone Marrow Diseases
(complications, drug therapy, microbiology)
- Edema
(complications, drug therapy, microbiology)
- Female
- Humans
- Intervertebral Disc Displacement
(complications)
- Low Back Pain
(complications, drug therapy, microbiology)
- Male
- Middle Aged
- Pilot Projects
- Prospective Studies
- Treatment Outcome
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