Antiinflammatory effects of enterically coated amoxicillin-clavulanic acid in active ulcerative colitis.
The inflammatory activity of colonic mucosal lesions may be stimulated by intraluminal bacteria. Our aim was to investigate whether administration of broad-spectrum antibiotics decreases inflammatory activity in ulcerative colitis. To this end, we performed a randomized, 5-day study with either oral enterically coated amoxicillin-clavulanic acid (1 g + 250 mg, t.i.d.); i.v. methylprednisolone (40 mg/day) and oral placebo (t.i.d.); or both i.v. methylprednisolone and oral amoxicillin-clavulanic acid as above, in 30 patients with clinically active ulcerative colitis. Before and after 5 days of treatment, intestinal inflammation was assessed by the quantification of mucosal release of eicosanoids and interleukin-8 by rectal dialysis in each patient. Breath H2 excretion after oral lactulose was determined as an index of metabolic activity of colonic flora. The total release of (IL-8) interleukin-8 and eicosanoids significantly decreased in patients treated with antibiotic or steroids and antibiotic. Antibiotic treatment, but not steroids, markedly inhibited breath H2 excretion. In conclusion, short-term treatment with enteric-coated amoxicillin-clavulanic acid decreases the intraluminal release of IL-8 and other inflammatory mediators.
Casellas
F
F
Digestive System Research Unit, Hospital General Vall d'Hebron, Barcelona, Spain.
Borruel
N
N
Papo
M
M
Guarner
F
F
Antolín
M
M
Videla
S
S
Malagelada
J R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000008:administration & dosage*; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000188:drug therapy* / Q000276:immunology; D004359:Drug Therapy, Combination / Q000008:administration & dosage*; D015777:Eicosanoids / Q000378:metabolism; D005260:Female; D006801:Humans; D016209:Interleukin-8 / Q000378:metabolism; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D013608:Tablets, Enteric-Coated
D000893:Anti-Inflammatory Agents; D015777:Eicosanoids; D016209:Interleukin-8; D013608:Tablets, Enteric-Coated; D019980:Amoxicillin-Potassium Clavulanate Combination; D008775:Methylprednisolone