Question: Is the antibiotic treatment for osteoarthritis a lot of hype or is there any truth to this? I am 54, and not overweight, yet I seem to be headed down the same path as my mother who is now 80 and has much difficulty walking.

Dr. Hibberd's Answer:

Osteoarthritis is a degenerative type of arthritic disorder that seems to affect some patients worse than others. Some have significant inflammation and pain with little erosive disease, while others have a more aggressive process. There has been some data suggesting this process may be precipitated by microbial disease, but the evidence and data does not support any sustained improvement in osteoarthritis with the use of random antimicrobial agents in non-infected joints.

There is, however, reasonable evidence published by investigators at Indiana University several years ago that doxycycline, 100mg twice daily for 30 months, decreased the loss of cartilage in knees affected by osteoarthritis through its anti-inflammatory properties, not through its anti-microbial. Despite this report, and several studies since then, we still have no FDA approval or rheumatological recommendation for doxycycline use in osteoarthritis patients.

The use of doxycycline for extended periods will foster the growth of resistant organisms which may place you at significant increased risk for severe and life-threatening complications from inflammation of the large and small intestines. The inflammation is caused by a bacteria (Clostridium difficile) whose growth is facilitated by extended courses of broad spectrum antibiotics to which it is resistant. The risk benefit ratio is a clear stumbling block here.