title: Use of antibiotics in the treatment of Crohn's disease.
abstract: Many data coming from animal models and clinical observations support an involvement of intestinal microbiota in the pathogenesis of Crohn's disease (CD). It is hypothesized in fact, that the development of chronic intestinal inflammation is caused by an abnormal immune response to normal flora in genetically susceptible hosts. The involvement of bacteria in CD inflammation has provided the rationale for including antibiotics in the therapeutic armamentarium. However, randomized controlled trials have failed to demonstrate an efficacy of these drugs in patients with active uncomplicated CD, even if a subgroup of patients with colonic location seems to get benefit from antibiotics. Nitroimidazole compounds have been shown to be efficacious in decreasing CD recurrence rates in operated patients, and the use of metronidazole and ciprofloxacin is recommended in perianal disease. However, the appearance of systemic side effects limits antibiotic long-term employment necessary for treating a chronic relapsing disease. Rifaximin, characterized by an excellent safety profile, has provided promising results in inducing remission of CD.
authors: Gastroenterology Operative Unit, Azienda Ospedaliera San Camillo-Forlanini, 00152 Rome, Italy. marialiascribano@virgilio.it
authors: Maria Lia
authors: ML
authors: Scribano
authors: Cosimo
authors: C
authors: Prantera
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D003424:Crohn Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D007422:Intestines / Q000187:drug effects* / Q000382:microbiology; D012074:Remission Induction; D055502:Secondary Prevention; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotics; Crohn’s disease; Gut microbiota; Mycobacteria