RESEARCH - Infection rate and use of antibiotics in patients with RA treated with MTX

August 6, 2009

ls of the Rheumatic Diseases 1994;53:224-228; doi:10.1136/ard.53.4.224

Infection rate and use of antibiotics in patients with rheumatoid

arthritis treated with methotrexate.

M J van der Veen, A van der Heide, A A Kruize, J W Bijlsma

Department of Rheumatology, University Hospital Utrecht, The Netherlands.

OBJECTIVE--To investigate prospectively the frequency and type of

infections and the use of antibiotics among patients with rheumatoid

arthritis (RA) on methotrexate (MTX) and patients with RA without MTX.

METHODS--Every three months for one year 77 patients on MTX and 151

patients without MTX were asked about infections and the use of

antibiotics by means of a standardised questionnaire. Medication was

checked with the pharmacist.

RESULTS--In the MTX group there were significantly more infections and

more antibiotic therapy. The relative risks for patients on MTX of

infection or antibiotics use were 1.52 (95% Confidence Interval (CI)

1.04-2.22) and 1.49 (95% CI 1.04-2.13), respectively. The relative

risk of MTX for respiratory tract infections was 1.43 (95% CI

0.96-2.14) and for skin infections 2.19 (95% CI 1.45-3.31). The

increased risks could only partly be explained by differences in

disease severity and were not related to either duration of MTX

therapy or use of prednisone. Three patients in the MTX group had

herpes zoster versus one in the control group.

CONCLUSIONS--Treatment with MTX increases the rate of infection and

thus the use of antibiotics but does not lead to serious complications

necessitating discontinuation of the drug.

Not an MD

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