Exciting new research from the University of Utrecht in the Netherlands shows how antibiotics treat arthritis.

Your intestines are loaded with good bacteria that help break down food and prevent disease. They also contain bad bacteria that cause disease. Two antibiotics, vancomycin and metronidazole, help kill bad bacteria, without also killing most good bacteria. Researchers gave vancomycin to rats that develop arthritis. The antibiotic blocked the arthritis and also caused a huge increase in the good bacteria called E. Coli, that lives normally in the healthy intestine. The greater the increase in E coli, the more likely the rat was to be cured of its arthritis.

Tobramycin and colistin are two antibiotics that specifically kill the good E. Coli that lives in healthy intestines. When the researchers gave these two antibiotics along with the vancomycin, the arthritis symptoms worsened and E. Coli concentrations in the intestines were markedly reduced. So the antibiotic, vancomycin, cleared the symptoms of arthritis only when it increased the concentration of the good E. Coli in the intestines. When other antibiotics prevented the rise in E. coli, the antibiotics were not effective.

This research shows that antibiotics may cure arthritis only when they kill the bad bacteria and increase the concentration of the good bacteria that live normally in the intestines. That means that further research will tell us if doctors can treat arthritis with metronidazole or vancomycin, the two antibiotics that knock of bad bacteria and increase the concentration of the good E. Coli that live normally in everyone’s intestines. These studies have not been done. See reports #J106 and #J159.

EES Nieuwenhuis, MR Visser, A Kavelaars, PM Cobelens, A Fleer, W Harmsen, J Verhoef, LMA Akkermans, CJ Heijnen. Oral antibiotics as a novel therapy for arthritis – Evidence for a beneficial effect of intestinal Escherichia coli. Arthritis and Rheumatism, 2000, Vol 43, Iss 11, pp 2583-2589Address Heijnen CJ, Univ Utrecht, Med Ctr, Wilhelmina Childrens Hosp, Dept Pediat Immunol, Room KC 03-068-0, Lundlaan 6, NL-3584 EA Utrecht, NETHERLANDS

Abstract: We investigated the effects of changing the intestinal flora on the course of adjuvant-induced arthritis (AIA) and on experimental autoimmune encephalomyelitis (EAE) by the use of oral antibiotics, Methods. Oral treatment with either vancomycin or vancomycin, tobramycin, and colistin was started after AIA and EAE induction, Clinical symptoms of AIA and EAE were monitored, and microbial analysis of ileal samples was performed. Results. Oral vancomycin treatment after disease induction significantly decreased clinical symptoms of AIA, Simultaneously, increased concentrations of Escherichia coli were detected in the distal ileum of vancomycin-treated rats. Ileal concentrations of E coli were inversely related to disease scores in rats with AIA, Coadministration of colistin/tobramycin to prevent the increase in E coli abrogated the beneficial effect of vancomycin on AIA. Vancomycin treatment also reduced the clinical symptoms of EAE. Conclusion. We propose oral vancomycin as a novel therapeutic strategy in autoimmune diseases.