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Antibiotics for treatment of inflammatory bowel diseases

R Balfour Sartor, MD
Section Editor
Paul Rutgeerts, MD, PhD, FRCP
Deputy Editor
Shilpa Grover, MD, MPH


Antibiotics have a well-established role in the treatment of septic complications of the inflammatory bowel diseases (IBD), such as abscesses and wound infections. In contrast, their benefit in the treatment of the primary disease processes of Crohn disease, ulcerative colitis, and pouchitis has not been well-established in carefully-designed clinical trials, although they are used commonly [1-4]. The rationale for antibiotic therapy in IBD is based upon a large body of evidence demonstrating that luminal bacteria and perhaps fungi and viruses have an important role in the pathogenesis of IBD [5-7]. (See "Immune and microbial mechanisms in the pathogenesis of inflammatory bowel disease".)

Treatment with antibiotics has the potential to influence the course of IBD by several mechanisms:

Decreasing the concentrations of bacteria and fungi in the gut lumen

Altering the composition of the intestinal microbiota to favor beneficial bacteria

Decreasing bacterial tissue invasion and treating microabscesses


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Literature review current through: Sep 2015. | This topic last updated: Jul 6, 2015.
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