Antibiotic Treatment in Patients with Chronic Low Back Pain and Modic Changes

MODIC is a multicenter project. Our group collaborates on antimicrobial resistance in patients with chronic low back pain. We are looking at the the effect of long-term use of antibiotics on the resistome of patients with chronic low back pain and Modic changes (MCs). 



Image may contain: Waist, Stomach, Arm, Hand, Abdomen.


The main aim of “Antibiotic-induced changes in the resistome of patients with chronic low back pain” is to investigate the effect of prolonged exposure to amoxicillin on the resistome and microbiome of the salivary and fecal microbial community. 


Long term antibiotic treatment is a new treatment strategy for patients with low back pain and vertebral endplate changes visible on MRI (Modic changes). However, there have been controversies regarding treatment efficacy.  In a recent multicenter study conducted in Norway, the results showed that there were no clinically significant differences between the antibiotic group and the placebo group in reported disability, pain intensity or quality of life at one year follow-up. Neither were there any clinically relevant differences in subgroups of patients, defined by the type of Modic changes or clinical information. As a part of this trial, saliva and fecal samples were collected to assess the impact of long term exposure of antibiotics (amoxicillin for 100 days) on the oral microbiome and resistome.

Effects of long term exposure to antibiotics

In this project, we are  using next generation deep sequencing and functional metagenomics to describe the effects of long term exposure of amoxicillin on the taxonomic and antimicrobial resistance profiles in the microbiome of patients that participated in this multicenter project.

Project leader:

Fernanda Petersen, UiO
Image may contain: Product, White-collar worker, Suit, Outerwear.
Professor Fernanda Petersen. Photo: Fredrik Haugen Pedersen, IOB/UiO

PhD candidates

Kjersti Sturød
Achal Dhariwal

Other participants

Roger Junges, postdoctoral fellow
Gabriela Salvadori da Silva, postdoctoral fellow 
Heidi Aarø Åmdal, head engineer

OUS main collaborators

Professor John-Anker Zwart  
Professor Kjersti Storheim
Professor Dag Berild
Dr Lars Christian Haugli Bråten


Published May 18, 2021 3:00 PM - Last modified May 18, 2021 3:00 PM