Pharmacologic management of the initial infection in Reactive Arthritis
Elimination of the “triggering” infection with appropriate antibiotics is the first therapeutic goal in ReA. This is especially true for acute Chlamydia infections (azithromycin 1 g single dose or doxycycline 100 mg twice daily for 7 days, patient and partner). Patients with a history of Chlamydia- related ReA should be evaluated for recurrent genitourinary infection if arthritis or genitourinary symptoms recur and should be retreated with antibiotics if testing for Chlamydia is positive. In general, antibiotics are not recommended for uncomplicated enteric infections. However, some patients with enteric infections may require treatment depending upon their comorbidities (e.g., age, immunocompromised) and/or severity of disease and type of organism (e.g., C. difficile ).