Antibiotics Therapy May Help Patients with Inflammatory Bowel Disease

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Inflammatory bowel disease (IBD) is a group of inflammatory conditions of the colon and small intestine. The major types of IBD are Crohn’s disease and ulcerative colitis.

Currently, there is no cure for IBD.  Patients are usually given steroids such as prednisone to reduce the inflammation. Once the inflammation is successfully controlled, the patient is usually switched to a lighter drug such as 5-ASA (Asacol) to keep the disease in remission.  If unsuccessful, a combination of the drugs including 5-ASA, azathioprine (Imuran), methotrexate, or 6-mercaptopurine might be used.  In severe cases, surgery is the only option.

Two new meta-analysis conducted by McMaster University Medical Center suggested that antibiotics may be an effective treatment option for ulcerative colitis and Crohn’s disease, suggesting inflammatory bowel disease (IBD) is of bacterial origin.

Crohn’s disease

The first analysis included 10 randomized trials and 1160 Crohn’s disease patients.   When compared with placebo, antibiotics (such as macrolides, fluoroquinolones, 5-nitroimidazoles, and rifaximin) were found to be more effective than placebo in inducing remission in patients with Crohn’s disease.

In particular, rifamycin derivatives either alone or in combination with other antibiotics appeared to have a significant effect at inducing remission in active Crohn’s disease.

There also were favorable findings in 123 patients with perianal Crohn’s disease fistula who used either ciprofloxacin or metronidazole. Antibiotic therapy also appeared to reduce relapse in 186 patients with quiescent disease.

Ulcerative colitis

The second analysis included 9 randomized controlled trials involving 662 patients with ulcerative colitis.  Once again, antibiotics were significantly more likely than placebo in inducing remission.

The authors concluded that antibiotics might be the new treatment alternatives for patients with IBD.  They, however, indicated further clinical trials are required to confirm the benefits of antibiotics.

If you have IBD and are not satisfied with the effects of current therapy, you might like to ask your physicians about antibiotics during your next doctor’s appointment.

Source: Am J Gastroenterol, 2011.

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