Trial reportJAMA network open2026
Efficacy of Antibiotics for Chronic Low Back Pain With Disc Herniation: A Randomized Clinical Trial.
Trial report in JAMA network open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Importance: Antibiotics are currently being recommended for chronic low back pain, particularly when treatments have failed, even though the evidence for their use is conflicting. Objective: To examine the efficacy and safety of antibiotics for the management of chronic low back pain with disc herniation at 12 months. Design, Setting, and Participants: A community-based, double-blind, placebo-controlled randomized clinical trial with telemedicine to recruit and follow up participants remotely was conducted. Participants aged 18 to 60 years with chronic low back pain and the presence of a disc herniation on magnetic resonance imaging (MRI) were randomized between January 20, 2016, and May 27, 2021. Data analysis was performed from June to November 2024. Intervention: Participants were randomly assigned to receive amoxicillin-clavulanate, 500/125 mg, or identical placebo twice per day for 90 days. Main Outcomes and Measures: The primary outcome was pain intensity measured using the Low Back Pain Rating Scale (score range, 0-10, with 0 indicating no pain and 10 indicating worst pain imaginable) at 12 months. Results: Of 415 participants assessed for eligibility, 170 (mean [SD] age, 44.4 [10.8] years; 101 [59.4%] male) were randomly assigned to receive amoxicillin-clavulanate (n = 85) or placebo (n = 85), and 152 (89.4%) provided primary outcome data at 12 months. Treatment with amoxicillin-clavulanate did not result in greater pain reduction than placebo at 12 months (adjusted difference, 0.06; 95% CI, -0.58 to 0.70) or 3 months (adjusted difference, 0.34; 95% CI, -0.18 to 0.86), independent of baseline pain. One participant in each group experienced a serious adverse event that was assessed as possibly related to the intervention, with 34 participants (40.0%) in the amoxicillin-clavulanate group and 20 (23.5%) in placebo group reporting any adverse event. Prespecified subgroup analyses showed no differences in pain between groups in those with Modic changes (bone changes detected on MRI). Conclusions and Relevance: This randomized clinical trial did not demonstrate efficacy of antibiotic therapy for chronic low back pain and disc herniation, including a subgroup with Modic changes. These findings suggest that antibiotics should not be used in the management of chronic low back pain and provide important data to prevent their inappropriate and harmful use. Trial Registration: http://anzctr.org.au Identifier: ACTRN12615000958583.
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