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Amid continuing concerns within the medical community about the overuse of antibiotics, which may result in the spread of antibiotic-resistent “superbug” infections, the findings of a new study suggest that the drugs provide little or no relief for treatment of chronic low back pain.
In findings published last month in the medical journal BMJ, researchers from Norway indicate there is no support for the practice of offering antibiotics to patients as a treatment for low back pain. Instead, they called for other interventions to be explored.
Researchers conducted a small double-blind study involving 180 patients treated at six hospitals in Norway, from June 2015 to September 2017. The patients experienced chronic low back pain or previous disc herniation. Additionally, they experienced one of two “Modic” changes, which is a change in the discs seen on imaging and can include signs of inflammation.
Researchers hypothesized some patients suffering from back pain with Modic changes might be suffering from a low-grade infection which would be the cause of the inflammation. Degenerative discs may provide a perfect place for the infection to grow, thus, treating low back pain in those cases could help relieve the underlying infection and eventually the pain.
Patients were randomly assigned to either three months of oral treatment of antibiotics or a placebo three times per day. The antibiotic group received 750 mg of amoxicillin daily.
Three months of treatment with amoxicillin failed to provide a clinically significant difference in the level of back pain experienced by patients compared with placebo. In addition, 56% of patients in the amoxicillin group experienced at least one drug related adverse event, compared to 34% of patients in the placebo group.
The amoxicillin group had lower disability scores than the placebo group, but it was a difference of only 1.6 points, which did not meet the threshold of being clinically important.
Chronic low back pain occurs in one-quarter of the adult population in the United States and leads to millions of annual office visits a year, missed workdays, and medical costs.
Unnecessary antibiotic use contributes to the proliferation of antibiotic resistant bacteria, experts warn. So-called “superbug” evolution is outpacing new antibiotic development as more and more bacteria becomes resistant to antibiotic treatment, according to recent research.
Recently, rare antibiotic resistant infections were found in 27 states across the U.S. Despite the known risks of superbug proliferation, health experts warn that antibiotics are still prescribed inappropriately in instances where they are not needed and do not treat the infection or problem in questions.
The findings of the new study do not support the use of antibiotic treatment for chronic low back pain and underscore the need for studies like this to highlight situations where antibiotics are unnecessary, the researchers concluded.