How to stop itching from bactrim ) and the use of antibiotics (which was also used on a large proportion of the women in our study). Some of these factors were known in both our study and this retrospective case-control study, had therefore been used to design the study. Overall, this retrospective case-control study supports the findings of a large observational study conducted in a similar group of women with RA in which use of methotrexate, azathioprine, clarithromycin and tetracycline was identified to be associated with an increased risk of post-infectious exacerbations RA [4]. We have therefore found that, after controlling for potential confounders, use of methotrexate at the time infection is independent of the incidence post-infectious exacerbations. We are not saying this is a panacea but there compelling evidence to suggest that an increasing number of RA patients are in treatment with antimicrobials. In terms of the limitations this study, fact that we did not directly measure other risk factors (e.g. smoking) would have meant we missed the possibility of a potential dose-dependent effect the antimicrobial treatment. However, we chose to report the incidence of exacerbations based on case definitions; this is a standard approach in medical research. The small number of RA patients recruited into the study meant we could not assess changes in the incidence of post-infectious exacerbations in our group of women taking antimicrobials long term.

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