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Two patients dropped out because of intolerance to the antibiotic medication (one patient on azithromycin and one patient on doxycycline).

After the end of the antibiotic therapy, only 12 patients completed the follow-up for a further 12 weeks, during which they were to continue the same antirheumatic medication - the study protocol did not allow antibiotics or any change of concomitant medication during this follow-up period.

Patients with axial disease and spondylitis were excluded in order to avoid the inclusion of patients with ankylosing spondylitis (Bechterew's disease).

Thirty patients agreed to antibiotic treatment (Figure Twenty-two out of 30 patients were on antirheumatic medications without antibiotics, with a stable dosage of the respective drugs at least 4 weeks prior to the beginning of this study (outlined in Table ).

The 27 patients treated with azithromycin received a loading dose of 500 mg on six successive days, followed by 500 mg twice a week.

We conducted a prospective, interventional study in patients treated at the Rheumatology Departments of the Hannover Medical School and the Saarland University Medical School, Germany.

The responsible ethics committee of Hannover Medical School, Germany approved the study.