Antibiotics are sometimes prescribed for lower back pain when more conventional therapies don't work, based on some studies showing bacteria in affected spinal discs.In this randomized trial, no benefit from amoxicillin-clavulanate could be discerned for patients with refractory low back pain and herniated discs at 1 year.The authors recommended that antibiotics no longer be prescribed for this indication.
Patients with lower back pain related to spinal disc herniation got no more relief from the antibiotic combination of amoxicillin and clavulanate than from placebo in a randomized trial, creating new confusion around this approach to the common and often stubborn condition.
With 170 patients randomized to amoxicillin-clavulanate or placebo, reductions in pain scores were virtually identical 12 months after starting a 3-month course of treatment, according to Donna M. Urquhart, PhD, of Monash University in Melbourne, Australia, and colleagues. This lack of difference was seen not only for the overall sample but also for a subset of patients with so-called Modic changes (i.e., vertebral bone degeneration).
Meanwhile, adverse events were considerably more frequent in the antibiotic-treated group (40.0% vs 23.5% with placebo), the group reported in JAMA Network Open.
