Antibiotic jab that can ease back pain

An INJECTION of acnefighting antibiotics could revolutionise the treatment of back pain. Doctors in the UK are testing whether a one-off jab of a new drug known as PP353 can ease — and even cure — the chronic lower back pain that affects millions.

the antibiotic kills bacteria that normally cause acne but have also been found lurking in the damaged spinal discs of patients with back pain.

three people have already been treated, and one has said that a ‘dramatic’ reduction in pain means he can go swimming again.

common causes of back pain include slipped discs, arthritis and spinal stenosis (where bones press on nerves) but there is growing evidence bacteria also play a role.

In a landmark 2013 study, Danish researchers found that in up to 40 per cent of patients with slipped discs, the damaged discs were infected with cutibacterium acnes bacteria.

the discs are spongy pieces of tissue that sit between and cushion the bones of the spine. when one slips or herniates, most commonly due to age-related wear and tear, part of its soft core bulges out and can press on nearby nerves.

cutibacterium acnes normally causes acne but is also found in the mouth and can get into the bloodstream as a result of poor dental hygiene.

Slipped discs grow small blood vessels as part of the repair process, and it’s thought this is how the bacteria enter the disc.

they then produce an acid that damages the surrounding bones, irritates the nerves and causes inflammation, leading to pain.

Studies have shown that oral antibiotics can ease the pain. But much of the drug is broken down before it reaches the spine, so the tablets have to be taken for at least three months to be effective. Such prolonged use raises the risk of side effects including diarrhoea, abdominal pain and loss of appetite, as well as concerns about antibiotic resistance, where bacteria develop the ability to defeat drugs meant to kill them.

the new treatment, developed by Kent-based Persica Pharmaceuticals, involves injecting the PP353 antibiotic into the disc. this maximises the amount of the drug that reaches the bacteria, allowing patients to be treated with a single injection, in turn reducing the risk of side effects and antibiotic resistance.

once injected, PP353 solidifies, which ensures it stays within the disc, stopping the bacteria from growing and causing pain.

A preliminary trial at hospitals in Preston and coventry found it to be safe and well tolerated. one of the three trial participants, 44-year-old Scot Harris, who has had lower back pain for five years, said: ‘the pain has dramatically reduced, and I can go swimming again and lead a more normal life that others take for granted.’

A larger trial, involving 40 patients, is now under way.

Michael Mcnicholas, a consultant orthopaedic surgeon at Liverpool University Hospitals nHS Foundation trust, said that the successful treatment of lower back pain with antibiotics could make surgery for it obsolete.

He added: ‘this groundbreaking work could transform life for millions of patients suffering with chronic back pain.’