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Nitrofurantoin
7%
223/3186
Rifampin
23%
736/3186
Azithromycin
6%
195/3186
Erythromycin
11%
343/3186
Doxycycline
53%
1676/3186
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Tetracycline was initially used in the treatment of rheumatoid arthritis (RA) because Mycoplasma was thought to be the causative agent. It was later found that tetracyclines have biologic effects on the inflammatory and immunologic cascade by inhibiting collagenase activity. Collagenase is an enzyme involved in breaking down macromolecules in the connective tissue, contributing to the pathologic changes of RA. In a prospective study, O'Dell et al found that initial therapy with methotrexate plus doxycycline was superior to treatment with methotrexate alone. Furthermore, similar results for low-dose and high-dose doxycycline suggested that antimetalloproteinase effects were more important than the antibacterial effects.
3.1
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