Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial
AbstractObjectiveTo assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes).DesignDouble blind, parallel group, placebo controlled, multicentre trial.SettingHosp...
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| Veröffentlicht in: | BMJ (Online) 2019-10, Vol.367, p.l5654-l5654 |
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| creator | Bråten, Lars Christian Haugli Rolfsen, Mads Peder Espeland, Ansgar Wigemyr, Monica Aßmus, Jörg Froholdt, Anne Haugen, Anne Julsrud Marchand, Gunn Hege Kristoffersen, Per Martin Lutro, Olav Randen, Sigrun Wilhelmsen, Maja Winsvold, Bendik Slagsvold Kadar, Thomas Istvan Holmgard, Thor Einar Vigeland, Maria Dehli Vetti, Nils Nygaard, Øystein Petter Lie, Benedicte Alexandra Hellum, Christian Anke, Audny Grotle, Margreth Schistad, Elina Iordanova Skouen, Jan Sture Grøvle, Lars Brox, Jens Ivar Zwart, John-Anker Storheim, Kjersti |
| description | AbstractObjectiveTo assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes).DesignDouble blind, parallel group, placebo controlled, multicentre trial.SettingHospital outpatient clinics at six hospitals in Norway.Participants180 patients with chronic low back pain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017.InterventionsPatients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription.Main outcome measuresThe primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention to treat population. The minimal clinically important between group difference in mean RMDQ score was predefined as 4.ResultsIn the primary analysis of the total cohort at one year, the difference in the mean RMDQ score between the amoxicillin group and the placebo group was −1.6 (95% confidence interval −3.1 to 0.0, P=0.04). In the secondary analysis, the difference in the mean RMDQ score between the groups was −2.3 (−4.2 to−0.4, P=0.02) for patients with type 1 Modic changes and −0.1 (−2.7 to 2.6, P=0.95) for patients with type 2 Modic changes. Fifty patients (56%) in the amoxicillin group experienced at least one drug related adverse event compared with 31 (34%) in the placebo group.ConclusionsIn this study on patients with chronic low back pain and Modic changes at the level of a previous disc herniation, three months of treatment with amoxicillin did not provide a clinically important benefit compared with placebo. Secondary analyses and sensitivity analyses supported this finding. Therefore, our results do not support the use of antibiotic treatment for chronic low back pain and Modic changes.Trial registrationClinicalTrials.gov NCT02323412. |
| doi_str_mv | 10.1136/bmj.l5654 |
| format | Article |
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The allocation sequence was concealed by using a computer generated number on the prescription.Main outcome measuresThe primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention to treat population. The minimal clinically important between group difference in mean RMDQ score was predefined as 4.ResultsIn the primary analysis of the total cohort at one year, the difference in the mean RMDQ score between the amoxicillin group and the placebo group was −1.6 (95% confidence interval −3.1 to 0.0, P=0.04). In the secondary analysis, the difference in the mean RMDQ score between the groups was −2.3 (−4.2 to−0.4, P=0.02) for patients with type 1 Modic changes and −0.1 (−2.7 to 2.6, P=0.95) for patients with type 2 Modic changes. Fifty patients (56%) in the amoxicillin group experienced at least one drug related adverse event compared with 31 (34%) in the placebo group.ConclusionsIn this study on patients with chronic low back pain and Modic changes at the level of a previous disc herniation, three months of treatment with amoxicillin did not provide a clinically important benefit compared with placebo. Secondary analyses and sensitivity analyses supported this finding. Therefore, our results do not support the use of antibiotic treatment for chronic low back pain and Modic changes.Trial registrationClinicalTrials.gov NCT02323412.</description><identifier>ISSN: 0959-8138</identifier><identifier>ISSN: 1756-1833</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.l5654</identifier><identifier>PMID: 31619437</identifier><language>eng</language><publisher>England: British Medical Journal Publishing Group</publisher><subject>Adult ; Amoxicillin ; Amoxicillin - administration & dosage ; Amoxicillin - adverse effects ; Anti-Bacterial Agents - administration & dosage ; Anti-Bacterial Agents - adverse effects ; Antibiotics ; Back pain ; Chronic Pain - diagnosis ; Chronic Pain - drug therapy ; Chronic Pain - etiology ; Disability Evaluation ; Double-Blind Method ; Double-blind studies ; Drug resistance ; Female ; Health sciences: 800 ; Helsefag: 800 ; Humans ; Intervertebral Disc Degeneration - complications ; Intervertebral Disc Displacement - complications ; Low back pain ; Low Back Pain - diagnosis ; Low Back Pain - drug therapy ; Low Back Pain - etiology ; Lumbar Vertebrae - diagnostic imaging ; Lumbar Vertebrae - pathology ; Male ; Medical disciplines: 700 ; Medisinske Fag: 700 ; Middle Aged ; NMR ; Norway ; Nuclear magnetic resonance ; Older people ; Pain Measurement - methods ; Patients ; Penicillin ; Questionnaires ; Sensitivity analysis ; Surgery ; Systematic review ; Treatment Outcome ; VDP ; Vertebrae</subject><ispartof>BMJ (Online), 2019-10, Vol.367, p.l5654-l5654</ispartof><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions 2019 BMJ http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>info:eu-repo/semantics/openAccess</rights><rights>Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to 2019 BMJ</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b486t-69a6d52bf42986514febd11a971e180a44cb24c8f4b3de67a4d3cea4dc9d1e353</citedby><cites>FETCH-LOGICAL-b486t-69a6d52bf42986514febd11a971e180a44cb24c8f4b3de67a4d3cea4dc9d1e353</cites><orcidid>0000-0002-2560-2556</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,26544,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31619437$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bråten, Lars Christian Haugli</creatorcontrib><creatorcontrib>Rolfsen, Mads Peder</creatorcontrib><creatorcontrib>Espeland, Ansgar</creatorcontrib><creatorcontrib>Wigemyr, Monica</creatorcontrib><creatorcontrib>Aßmus, Jörg</creatorcontrib><creatorcontrib>Froholdt, Anne</creatorcontrib><creatorcontrib>Haugen, Anne Julsrud</creatorcontrib><creatorcontrib>Marchand, Gunn Hege</creatorcontrib><creatorcontrib>Kristoffersen, Per Martin</creatorcontrib><creatorcontrib>Lutro, Olav</creatorcontrib><creatorcontrib>Randen, Sigrun</creatorcontrib><creatorcontrib>Wilhelmsen, Maja</creatorcontrib><creatorcontrib>Winsvold, Bendik Slagsvold</creatorcontrib><creatorcontrib>Kadar, Thomas Istvan</creatorcontrib><creatorcontrib>Holmgard, Thor Einar</creatorcontrib><creatorcontrib>Vigeland, Maria Dehli</creatorcontrib><creatorcontrib>Vetti, Nils</creatorcontrib><creatorcontrib>Nygaard, Øystein Petter</creatorcontrib><creatorcontrib>Lie, Benedicte Alexandra</creatorcontrib><creatorcontrib>Hellum, Christian</creatorcontrib><creatorcontrib>Anke, Audny</creatorcontrib><creatorcontrib>Grotle, Margreth</creatorcontrib><creatorcontrib>Schistad, Elina Iordanova</creatorcontrib><creatorcontrib>Skouen, Jan Sture</creatorcontrib><creatorcontrib>Grøvle, Lars</creatorcontrib><creatorcontrib>Brox, Jens Ivar</creatorcontrib><creatorcontrib>Zwart, John-Anker</creatorcontrib><creatorcontrib>Storheim, Kjersti</creatorcontrib><creatorcontrib>AIM study group</creatorcontrib><title>Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><addtitle>BMJ</addtitle><description>AbstractObjectiveTo assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes).DesignDouble blind, parallel group, placebo controlled, multicentre trial.SettingHospital outpatient clinics at six hospitals in Norway.Participants180 patients with chronic low back pain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017.InterventionsPatients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription.Main outcome measuresThe primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention to treat population. The minimal clinically important between group difference in mean RMDQ score was predefined as 4.ResultsIn the primary analysis of the total cohort at one year, the difference in the mean RMDQ score between the amoxicillin group and the placebo group was −1.6 (95% confidence interval −3.1 to 0.0, P=0.04). In the secondary analysis, the difference in the mean RMDQ score between the groups was −2.3 (−4.2 to−0.4, P=0.02) for patients with type 1 Modic changes and −0.1 (−2.7 to 2.6, P=0.95) for patients with type 2 Modic changes. Fifty patients (56%) in the amoxicillin group experienced at least one drug related adverse event compared with 31 (34%) in the placebo group.ConclusionsIn this study on patients with chronic low back pain and Modic changes at the level of a previous disc herniation, three months of treatment with amoxicillin did not provide a clinically important benefit compared with placebo. Secondary analyses and sensitivity analyses supported this finding. Therefore, our results do not support the use of antibiotic treatment for chronic low back pain and Modic changes.Trial registrationClinicalTrials.gov NCT02323412.</description><subject>Adult</subject><subject>Amoxicillin</subject><subject>Amoxicillin - administration & dosage</subject><subject>Amoxicillin - adverse effects</subject><subject>Anti-Bacterial Agents - administration & dosage</subject><subject>Anti-Bacterial Agents - adverse effects</subject><subject>Antibiotics</subject><subject>Back pain</subject><subject>Chronic Pain - diagnosis</subject><subject>Chronic Pain - drug therapy</subject><subject>Chronic Pain - etiology</subject><subject>Disability Evaluation</subject><subject>Double-Blind Method</subject><subject>Double-blind studies</subject><subject>Drug resistance</subject><subject>Female</subject><subject>Health sciences: 800</subject><subject>Helsefag: 800</subject><subject>Humans</subject><subject>Intervertebral Disc Degeneration - complications</subject><subject>Intervertebral Disc Displacement - complications</subject><subject>Low back pain</subject><subject>Low Back Pain - diagnosis</subject><subject>Low Back Pain - drug therapy</subject><subject>Low Back Pain - etiology</subject><subject>Lumbar Vertebrae - diagnostic imaging</subject><subject>Lumbar Vertebrae - pathology</subject><subject>Male</subject><subject>Medical disciplines: 700</subject><subject>Medisinske Fag: 700</subject><subject>Middle Aged</subject><subject>NMR</subject><subject>Norway</subject><subject>Nuclear magnetic resonance</subject><subject>Older people</subject><subject>Pain Measurement - methods</subject><subject>Patients</subject><subject>Penicillin</subject><subject>Questionnaires</subject><subject>Sensitivity analysis</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Treatment Outcome</subject><subject>VDP</subject><subject>Vertebrae</subject><issn>0959-8138</issn><issn>1756-1833</issn><issn>1756-1833</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>9YT</sourceid><sourceid>ACMMV</sourceid><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><sourceid>3HK</sourceid><recordid>eNp9kl1rFDEUhgdR7FJ74R_QgAotODWZZDIZL4RSqhZavNHrkK_pZM0ka5Kx7F_yV5rdbdcv8CYJ5zznPW8Op6qeIniKEKZv5LQ8dS1tyYNqgbqW1ohh_LBawL7ta4YwO6iOUlpCCBvcsZ62j6sDjCjqCe4W1Y-LYbBKqDUIAxA-W2lDtgrkaESejM_AerAS2ZZnArc2j0CNMfiCuHALpFBfS7owwmtwHXSJq1H4G5PAcR4NOLu8BinPen3yFugwS2eAdNbr1yCWijDZZMp75YQyMgAVfI7BuU1sml0xUtpGU9xY4Z5Ujwbhkjm6uw-rL-8vPp9_rK8-fbg8P7uqJWE017QXVLeNHEjTM9oiMhipERJ9hwxiUBCiZEMUG4jE2tBOEI2VKafqNTK4xYfVu53uapaT0VsLwvFVtJOIax6E5X9mvB35TfjOKUMNRaQIPN8JqGhTtp77EAVHEOKOow6TrhDHdy1i-DablHkZhDLOCW_CnHiDISV910BW0Bd_ocswR18GsKUgaRDdeD65bxlSimbY20WQb9aElzXh2zUp7LPf_7cn75eiAC93wKbmfzqvfmF7U_9yPwGWW9Id</recordid><startdate>20191016</startdate><enddate>20191016</enddate><creator>Bråten, 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Kjersti</creator><general>British Medical Journal Publishing Group</general><general>BMJ Publishing Group LTD</general><general>BMJ</general><general>BMJ Publishing Group 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of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial</title><author>Bråten, Lars Christian Haugli ; Rolfsen, Mads Peder ; Espeland, Ansgar ; Wigemyr, Monica ; Aßmus, Jörg ; Froholdt, Anne ; Haugen, Anne Julsrud ; Marchand, Gunn Hege ; Kristoffersen, Per Martin ; Lutro, Olav ; Randen, Sigrun ; Wilhelmsen, Maja ; Winsvold, Bendik Slagsvold ; Kadar, Thomas Istvan ; Holmgard, Thor Einar ; Vigeland, Maria Dehli ; Vetti, Nils ; Nygaard, Øystein Petter ; Lie, Benedicte Alexandra ; Hellum, Christian ; Anke, Audny ; Grotle, Margreth ; Schistad, Elina Iordanova ; Skouen, Jan Sture ; Grøvle, Lars ; Brox, Jens Ivar ; Zwart, John-Anker ; Storheim, Kjersti</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b486t-69a6d52bf42986514febd11a971e180a44cb24c8f4b3de67a4d3cea4dc9d1e353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Amoxicillin</topic><topic>Amoxicillin - administration & dosage</topic><topic>Amoxicillin - adverse effects</topic><topic>Anti-Bacterial Agents - administration & dosage</topic><topic>Anti-Bacterial Agents - adverse effects</topic><topic>Antibiotics</topic><topic>Back pain</topic><topic>Chronic Pain - diagnosis</topic><topic>Chronic Pain - drug therapy</topic><topic>Chronic Pain - etiology</topic><topic>Disability Evaluation</topic><topic>Double-Blind Method</topic><topic>Double-blind studies</topic><topic>Drug resistance</topic><topic>Female</topic><topic>Health sciences: 800</topic><topic>Helsefag: 800</topic><topic>Humans</topic><topic>Intervertebral Disc Degeneration - complications</topic><topic>Intervertebral Disc Displacement - complications</topic><topic>Low back pain</topic><topic>Low Back Pain - diagnosis</topic><topic>Low Back Pain - drug therapy</topic><topic>Low Back Pain - etiology</topic><topic>Lumbar Vertebrae - diagnostic imaging</topic><topic>Lumbar Vertebrae - pathology</topic><topic>Male</topic><topic>Medical disciplines: 700</topic><topic>Medisinske Fag: 700</topic><topic>Middle Aged</topic><topic>NMR</topic><topic>Norway</topic><topic>Nuclear magnetic resonance</topic><topic>Older people</topic><topic>Pain Measurement - methods</topic><topic>Patients</topic><topic>Penicillin</topic><topic>Questionnaires</topic><topic>Sensitivity analysis</topic><topic>Surgery</topic><topic>Systematic review</topic><topic>Treatment Outcome</topic><topic>VDP</topic><topic>Vertebrae</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bråten, Lars Christian Haugli</creatorcontrib><creatorcontrib>Rolfsen, Mads 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Audny</creatorcontrib><creatorcontrib>Grotle, Margreth</creatorcontrib><creatorcontrib>Schistad, Elina Iordanova</creatorcontrib><creatorcontrib>Skouen, Jan Sture</creatorcontrib><creatorcontrib>Grøvle, Lars</creatorcontrib><creatorcontrib>Brox, Jens Ivar</creatorcontrib><creatorcontrib>Zwart, John-Anker</creatorcontrib><creatorcontrib>Storheim, Kjersti</creatorcontrib><creatorcontrib>AIM study group</creatorcontrib><collection>BMJ Open Access Journals</collection><collection>BMJ Journals:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Science 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Present)</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>SciTech Premium Collection</collection><collection>British Nursing Index</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Research Library</collection><collection>Science Database</collection><collection>Biological Science Database</collection><collection>Research Library (Corporate)</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>NORA - Norwegian Open Research Archives</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BMJ (Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bråten, Lars Christian Haugli</au><au>Rolfsen, Mads Peder</au><au>Espeland, Ansgar</au><au>Wigemyr, Monica</au><au>Aßmus, Jörg</au><au>Froholdt, Anne</au><au>Haugen, Anne Julsrud</au><au>Marchand, Gunn Hege</au><au>Kristoffersen, Per Martin</au><au>Lutro, Olav</au><au>Randen, Sigrun</au><au>Wilhelmsen, Maja</au><au>Winsvold, Bendik Slagsvold</au><au>Kadar, Thomas Istvan</au><au>Holmgard, Thor Einar</au><au>Vigeland, Maria Dehli</au><au>Vetti, Nils</au><au>Nygaard, Øystein Petter</au><au>Lie, Benedicte Alexandra</au><au>Hellum, Christian</au><au>Anke, Audny</au><au>Grotle, Margreth</au><au>Schistad, Elina Iordanova</au><au>Skouen, Jan Sture</au><au>Grøvle, Lars</au><au>Brox, Jens Ivar</au><au>Zwart, John-Anker</au><au>Storheim, Kjersti</au><aucorp>AIM study group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial</atitle><jtitle>BMJ (Online)</jtitle><stitle>BMJ</stitle><addtitle>BMJ</addtitle><date>2019-10-16</date><risdate>2019</risdate><volume>367</volume><spage>l5654</spage><epage>l5654</epage><pages>l5654-l5654</pages><issn>0959-8138</issn><issn>1756-1833</issn><eissn>1756-1833</eissn><abstract>AbstractObjectiveTo assess the efficacy of three months of antibiotic treatment compared with placebo in patients with chronic low back pain, previous disc herniation, and vertebral endplate changes (Modic changes).DesignDouble blind, parallel group, placebo controlled, multicentre trial.SettingHospital outpatient clinics at six hospitals in Norway.Participants180 patients with chronic low back pain, previous disc herniation, and type 1 (n=118) or type 2 (n=62) Modic changes enrolled from June 2015 to September 2017.InterventionsPatients were randomised to three months of oral treatment with either 750 mg amoxicillin or placebo three times daily. The allocation sequence was concealed by using a computer generated number on the prescription.Main outcome measuresThe primary outcome was the Roland-Morris Disability Questionnaire (RMDQ) score (range 0-24) at one year follow-up in the intention to treat population. The minimal clinically important between group difference in mean RMDQ score was predefined as 4.ResultsIn the primary analysis of the total cohort at one year, the difference in the mean RMDQ score between the amoxicillin group and the placebo group was −1.6 (95% confidence interval −3.1 to 0.0, P=0.04). In the secondary analysis, the difference in the mean RMDQ score between the groups was −2.3 (−4.2 to−0.4, P=0.02) for patients with type 1 Modic changes and −0.1 (−2.7 to 2.6, P=0.95) for patients with type 2 Modic changes. Fifty patients (56%) in the amoxicillin group experienced at least one drug related adverse event compared with 31 (34%) in the placebo group.ConclusionsIn this study on patients with chronic low back pain and Modic changes at the level of a previous disc herniation, three months of treatment with amoxicillin did not provide a clinically important benefit compared with placebo. Secondary analyses and sensitivity analyses supported this finding. Therefore, our results do not support the use of antibiotic treatment for chronic low back pain and Modic changes.Trial registrationClinicalTrials.gov NCT02323412.</abstract><cop>England</cop><pub>British Medical Journal Publishing Group</pub><pmid>31619437</pmid><doi>10.1136/bmj.l5654</doi><orcidid>https://orcid.org/0000-0002-2560-2556</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0959-8138 |
| ispartof | BMJ (Online), 2019-10, Vol.367, p.l5654-l5654 |
| issn | 0959-8138 1756-1833 1756-1833 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6812614 |
| source | Jstor Complete Legacy; MEDLINE; NORA - Norwegian Open Research Archives |
| subjects | Adult Amoxicillin Amoxicillin - administration & dosage Amoxicillin - adverse effects Anti-Bacterial Agents - administration & dosage Anti-Bacterial Agents - adverse effects Antibiotics Back pain Chronic Pain - diagnosis Chronic Pain - drug therapy Chronic Pain - etiology Disability Evaluation Double-Blind Method Double-blind studies Drug resistance Female Health sciences: 800 Helsefag: 800 Humans Intervertebral Disc Degeneration - complications Intervertebral Disc Displacement - complications Low back pain Low Back Pain - diagnosis Low Back Pain - drug therapy Low Back Pain - etiology Lumbar Vertebrae - diagnostic imaging Lumbar Vertebrae - pathology Male Medical disciplines: 700 Medisinske Fag: 700 Middle Aged NMR Norway Nuclear magnetic resonance Older people Pain Measurement - methods Patients Penicillin Questionnaires Sensitivity analysis Surgery Systematic review Treatment Outcome VDP Vertebrae |
| title | Efficacy of antibiotic treatment in patients with chronic low back pain and Modic changes (the AIM study): double blind, randomised, placebo controlled, multicentre trial |
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