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Antibiotics for inflammatory bowel disease: Current status

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Abstract

There is abundant literature reporting about the use of antibiotics in inflammatory bowel disease (IBD), but their role in the management of IBD is not entirely clear. Diverse infectious organisms have been implicated in the pathogenesis of Crohn’s disease. Also, infections are believed to be a trigger for flares of ulcerative colitis. The benefit of the routine use of antibiotics in IBD is equivocal. However, there are certain situations, where antibiotics have a clear role and evidence of benefit: perianal fistula, intra-abdominal abscesses in Crohn’s disease, acute pouchitis and infection-related flares. However, there is a lack of supportive evidence for the routine use of antibiotics in all disease-related flares. Evidence indicates a lack of benefit of intravenous antibiotics in acute severe ulcerative colitis and only limited benefit in active ulcerative colitis. Limited evidence suggests the role of a combination of oral antibiotics in pediatric ulcerative colitis. Certain targeted antibiotic regimens have been used in IBD. In ulcerative colitis, limited evidence suggests the benefit of the use of an antibiotic cocktail directed against Fusobacterium varium. Therapy directed against Escherichia coli does not seem to have a benefit in inflammatory Crohn’s disease. In Crohn’s disease, antimycobacterial therapy may result in symptomatic improvement but no durable benefit. Antitubercular therapy (ATT), on the contrary, may result in fibrotic transformation, suggesting a need to avoid misdiagnosis and limit the duration of ATT in Crohn’s disease. This review assesses the published literature with respect to antibiotic use and provides guidance to clinicians in appropriate antibiotic use in various situations in the setting of IBD.

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References

  1. Aswani-Omprakash T, Sharma V, Bishu S, et al. Addressing unmet needs from a new frontier of IBD: the South Asian IBD Alliance. Lancet Gastroenterol Hepatol. 2021;6:884–5.

    Article  PubMed  Google Scholar 

  2. Roda G, Chien Ng S, Kotze PG, et al. Crohn’s disease. Nat Rev Dis Primers. 2020;6:22.

    Article  PubMed  Google Scholar 

  3. Shen ZH, Zhu CX, Quan YS, et al. Relationship between intestinal microbiota and ulcerative colitis: mechanisms and clinical application of probiotics and fecal microbiota transplantation. World J Gastroenterol. 2018;24:5–14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Halfvarson J, Brislawn CJ, Lamendella R, et al. Dynamics of the human gut microbiome in inflammatory bowel disease. Nat Microbiol. 2017;2:17004.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Mizoguchi A, Mizoguchi E. Animal models of IBD: linkage to human disease. Curr Opin Pharmacol. 2010;10:578–87.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Nitzan O, Elias M, Peretz A, Saliba W. Role of antibiotics for treatment of inflammatory bowel disease. World J Gastroenterol. 2016;22:1078–87.

  7. Singh A, Mahajan R, Kahlon BK, et al. Early fecal microbiome transfer after donor defecation determines response in patients with moderate to severe ulcerative colitis. Indian J Gastroenterol. 2022;41:389–96.

  8. Labro MT. Antibiotics as anti-inflammatory agents. Curr Opin Investig Drugs. 2002;3:61–8.

  9. Mylonaki M, Langmead L, Pantes A, Johnson F, Rampton DS. Enteric infection in relapse of inflammatory bowel disease: importance of microbiological examination of stool. Eur J Gastroenterol Hepatol. 2004;16:775–8.

  10. Axelrad JE, Joelson A, Green PHR, et al. Enteric infections are common in patients with flares of inflammatory bowel disease. Am J Gastroenterol. 2018;113:1530–9.

  11. Navarro-Llavat M, Domènech E, Bernal I, et al. Prospective, observational, cross-sectional study of intestinal infections among acutely active inflammatory bowel disease patients. Digestion. 2009;80:25–9.

  12. Yamamoto-Furusho JK, Torijano-Carrera E. Intestinal protozoa infections among patients with ulcerative colitis: prevalence and impact on clinical disease course. Digestion. 2010;82:18–23.

  13. Banerjee D, Deb R, Dar L, et al. High frequency of parasitic and viral stool pathogens in patients with active ulcerative colitis: report from a tropical country. Scand J Gastroenterol. 2009;44:325–31.

  14. Hokama A, Tomiyama R. Ulcerative colitis exacerbated by strongyloidiasis. Rev Esp Enferm Dig. 2023;115:102–3.

  15. Kucharzik T, Ellul P, Greuter T, et al. ECCO guidelines on the prevention, diagnosis, and management of infections in inflammatory bowel disease. J Crohns Colitis. 2021;15:879–913.

  16. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; final report on a therapeutic trial. Br Med J. 1955;2:1041–8.

  17. Chapman RW, Selby WS, Jewell DP. Controlled trial of intravenous metronidazole as an adjunct to corticosteroids in severe ulcerative colitis. Gut. 1986;27:1210–2.

  18. Mantzaris GJ, Hatzis A, Kontogiannis P, Triadaphyllou G. Intravenous tobramycin and metronidazole as an adjunct to corticosteroids in acute, severe ulcerative colitis. Am J Gastroenterol. 1994;89:43–6.

  19. Mantzaris GJ, Petraki K, Archavlis E, et al. A prospective randomized controlled trial of intravenous ciprofloxacin as an adjunct to corticosteroids in acute, severe ulcerative colitis. Scand J Gastroenterol. 2001;36:971–4. https://doi.org/10.1080/003655201750305503.

  20. Mishra S, Mandavdhare HS, Singh H, et al. Adjuvant use of combination of antibiotics in acute severe ulcerative colitis: a placebo controlled randomized trial. Expert Rev Anti Infect Ther. 2021;19:949–55.

  21. Turner D, Bishai J, Reshef L, et al. Antibiotic cocktail for pediatric acute severe colitis and the microbiome: the PRASCO randomized controlled trial. Inflamm Bowel Dis. 2020;26:1733–42.

  22. Mishra S, Jha DK, Singh AK, Kumar-M P, Patil A, Sharma V. Antibiotics for induction and maintenance of remission in ulcerative colitis: systematic review and meta-analysis. Expert Rev Gastroenterol Hepatol. 2021;15:1215–23.

  23. Dickinson RJ, O’Connor HJ, Pinder I, Hamilton I, Johnston D, Axon AT. Double blind controlled trial of oral vancomycin as adjunctive treatment in acute exacerbations of idiopathic colitis. Gut. 1985;26:1380–4.

  24. Burke DA, Axon AT, Clayden SA, Dixon MF, Johnston D, Lacey RW. The efficacy of tobramycin in the treatment of ulcerative colitis. Aliment Pharmacol Ther. 1990;4:123–9.

  25. Gionchetti P, Rizzello F, Ferrieri A, et al. Rifaximin in patients with moderate or severe ulcerative colitis refractory to steroid-treatment: a double-blind, placebo-controlled trial. Dig Dis Sci. 1999;44:1220–1.

  26. Casellas F, Borruel N, Papo M, et al. Antiinflammatory effects of enterically coated amoxicillin-clavulanic acid in active ulcerative colitis. Inflamm Bowel Dis. 1998;4:1–5.

  27. Mantzaris GJ, Archavlis E, Christoforidis P, et al. A prospective randomized controlled trial of oral ciprofloxacin in acute ulcerative colitis. Am J Gastroenterol. 1997;92:454–6.

  28. Petersen AM, Mirsepasi H, Halkjær SI, Mortensen EM, Nordgaard-Lassen I, Krogfelt KA. Ciprofloxacin and probiotic Escherichia coli Nissle add-on treatment in active ulcerative colitis: a double-blind randomized placebo controlled clinical trial. J Crohns Colitis. 2014;8:1498–505.

  29. Gilat T, Suissa A, Leichtman G, et al. A comparative study of metronidazole and sulfasalazine in active, not severe, ulcerative colitis. An Israeli multicenter trial. J Clin Gastroenterol. 1987;9:415–7.

  30. Ohkusa T, Nomura T, Terai T, et al. Effectiveness of antibiotic combination therapy in patients with active ulcerative colitis: a randomized, controlled pilot trial with long-term follow-up. Scand J Gastroenterol. 2005;40:1334–42.

  31. Ohkusa T, Kato K, Terao S, et al. Newly developed antibiotic combination therapy for ulcerative colitis: a double-blind placebo-controlled multicenter trial. Am J Gastroenterol. 2010;105:1820–9.

  32. Turunen UM, Färkkilä MA, Hakala K, et al. Long-term treatment of ulcerative colitis with ciprofloxacin: a prospective, double-blind, placebo-controlled study. Gastroenterology. 1998;115:1072–8.

  33. Gilat T, Leichtman G, Delpre G, Eshchar J, Bar Meir S, Fireman Z. A comparison of metronidazole and sulfasalazine in the maintenance of remission in patients with ulcerative colitis. J Clin Gastroenterol. 1989;11:392–5.

  34. Lobo AJ, Burke DA, Sobala GM, Axon AT. Oral tobramycin in ulcerative colitis: effect on maintenance of remission. Aliment Pharmacol Ther. 1993;7:155–8.

  35. Ohkusa T, Okayasu I, Ogihara T, Morita K, Ogawa M, Sato N. Induction of experimental ulcerative colitis by Fusobacterium varium isolated from colonic mucosa of patients with ulcerative colitis. Gut. 2003;52:79–83.

  36. Gupta V, Rodrigues R, Nguyen D, et al. Adjuvant use of antibiotics with corticosteroids in inflammatory bowel disease exacerbations requiring hospitalisation: a retrospective cohort study and meta-analysis. Aliment Pharmacol Ther. 2016;43:52–60.

  37. Bernstein CN, Eliakim A, Fedail S, et al. World Gastroenterology Organisation Global Guidelines inflammatory bowel disease: update August 2015. J Clin Gastroenterol. 2016;50:803–18.

  38. Lamb CA, Kennedy NA, Raine T, et al. British Society of Gastroenterology consensus guidelines on the management of inflammatory bowel disease in adults [published correction appears in Gut. 2021 ;70:1].  Gut. 2019;68 Suppl 3:s1–106.

  39. Torres J, Bonovas S, Doherty G, et al. ECCO Guidelines on therapeutics in Crohn’s disease: medical treatment. J Crohns Colitis. 2020;14:4–22.

  40. Scribano ML, Prantera C. Use of antibiotics in the treatment of Crohn’s disease. World J Gastroenterol. 2013;19:648–53.

  41. Choudhury A, Dhillon J, Sekar A, Gupta P, Singh H, Sharma V. Differentiating gastrointestinal tuberculosis and Crohn’s disease- a comprehensive review. BMC Gastroenterol. 2023;23:246.

  42. Townsend CM, Parker CE, MacDonald JK, et al. Antibiotics for induction and maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2019;2:CD012730.

  43. Blichfeldt P, Blomhoff JP, Myhre E, Gjone E. Metronidazole in Crohn’s disease. A double blind cross-over clinical trial. Scand J Gastroenterol. 1978;13:123–7.

  44. Sutherland L, Singleton J, Sessions J, et al. Double-blind, placebo-controlled trial of metronidazole in Crohn’s disease. Gut. 1991;32:1071–5.

  45. Ursing B, Alm T, Bárány F, et al. A comparative study of metronidazole and sulfasalazine for active Crohn’s disease: the cooperative Crohn’s disease study in Sweden II. Result. Gastroenterology. 1982;83:550–62.

  46. Arnold GL, Beaves MR, Pryjdun VO, Mook WJ. Preliminary study of ciprofloxacin in active Crohn’s disease. Inflamm Bowel Dis. 2002;8:10–5.

  47. Colombel JF, Lémann M, Cassagnou M, et al. A controlled trial comparing ciprofloxacin with mesalazine for the treatment of active Crohn’s disease. Groupe d’Etudes Thérapeutiques des Affections Inflammatoires Digestives (GETAID). Am J Gastroenterol. 1999;94:674–8.

  48. Steinhart AH, Feagan BG, Wong CJ, et al. Combined budesonide and antibiotic therapy for active Crohn’s disease: a randomized controlled trial. Gastroenterology. 2002;123:33–40.

  49. Prantera C, Zannoni F, Scribano ML, et al. An antibiotic regimen for the treatment of active Crohn’s disease: a randomized, controlled clinical trial of metronidazole plus ciprofloxacin. Am J Gastroenterol. 1996;91:328–32.

  50. Prantera C, Lochs H, Campieri M, et al. Antibiotic treatment of Crohn’s disease: results of a multicentre, double blind, randomized, placebo-controlled trial with rifaximin. Aliment Pharmacol Ther. 2006;23:1117–25.

  51. Prantera C, Lochs H, Grimaldi M, et al. Rifaximin-extended intestinal release induces remission in patients with moderately active Crohn’s disease. Gastroenterology. 2012;142:473–81.

  52. Lee SD, Singla A, Rulyak SJ, Clark-Snustad K. Double-blind, randomised, placebo-controlled crossover trial to evaluate the clinical efficacy of rifaximin in patients with moderate to severe active Crohn’s disease. GastroHep. 2020;2:185–92.

    Article  Google Scholar 

  53. Nitzan O, Elias M, Peretz A, Saliba W. Role of antibiotics for treatment of inflammatory bowel disease. World J Gastroenterol. 2016;22:1078–87.

  54. Ambrose NS, Allan RN, Keighley MR, et al. Antibiotic therapy for treatment in relapse of intestinal Crohn’s disease. A prospective randomized study. Dis Colon Rectum. 1985;28(2):81–5.

  55. Leiper K, Martin K, Ellis A, Watson AJ, Morris AI, Rhodes JM. Clinical trial: randomized study of clarithromycin versus placebo in active Crohn’s disease. Aliment Pharmacol Ther. 2008;27:1233–9.

  56. Rhodes JM, Subramanian S, Flanagan PK, et al. Randomized trial of ciprofloxacin doxycycline and hydroxychloroquine versus budesonide in active Crohn’s disease. Dig Dis Sci. 2021;66:2700–11.

  57. Panés J, Rimola J. Perianal fistulizing Crohn’s disease: pathogenesis, diagnosis and therapy. Nat Rev Gastroenterol Hepatol. 2017;14:652–64.

  58. Wetwittayakhlang P, Al Khoury A, Hahn GD, Lakatos PL. The optimal management of fistulizing Crohn’s disease: evidence beyond randomized clinical trials. J Clin Med. 2022;11:3045.

  59. Thia KT, Mahadevan U, Feagan BG, et al. Ciprofloxacin or metronidazole for the treatment of perianal fistulas in patients with Crohn’s disease: a randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis. 2009;15:17–24.

  60. Maeda Y, Ng SC, Durdey P, et al. Randomized clinical trial of metronidazole ointment versus placebo in perianal Crohn’s disease. Br J Surg. 2010;97:1340–7.

  61. Su JW, Ma JJ, Zhang HJ. Use of antibiotics in patients with Crohn’s disease: a systematic review and meta-analysis. J Dig Dis. 2015;16:58–66.

  62. West RL, van der Woude CJ, Hansen BE, et al. Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn’s disease with infliximab: a double-blind placebo-controlled study. Aliment Pharmacol Ther. 2004;20:1329–36.

  63. Dewint P, Hansen BE, Verhey E, et al. Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn’s disease: a randomised, double-blind, placebo controlled trial (ADAFI). Gut. 2014;63:292–9.

  64. Richards RJ. Management of abdominal and pelvic abscess in Crohn’s disease. World J Gastrointest Endosc. 2011;3:209–12.

  65. Clancy C, Boland T, Deasy J, McNamara D, Burke JP. A meta-analysis of percutaneous drainage versus surgery as the initial treatment of Crohn’s disease-related intra-abdominal abscess. J Crohns Colitis. 2016;10:202–8.

  66. Feagins LA, Holubar SD, Kane SV, Spechler SJ. Current strategies in the management of intra-abdominal abscesses in Crohn’s disease. Clin Gastroenterol Hepatol. 2011;9:842–50.

  67. De Groof EJ, Carbonnel F, Buskens CJ, Bemelman WA. Abdominal abscess in Crohn’s disease: multidisciplinary management. Dig Dis. 2014;32 Suppl 1:103–9.

  68. Vuitton L, Peyrin-Biroulet L. Pharmacological prevention of postoperative recurrence in Crohn’s disease. Drugs. 2020;80:385–99.

  69. Rutgeerts P, Hiele M, Geboes K, et al. Controlled trial of metronidazole treatment for prevention of Crohn’s recurrence after ileal resection. Gastroenterology. 1995;108:1617–21.

  70. Rutgeerts P, Van Assche G, Vermeire S, et al. Ornidazole for prophylaxis of postoperative Crohn’s disease recurrence: a randomized, double-blind, placebo-controlled trial. Gastroenterology. 2005;128:856–61.

  71. Herfarth HH, Katz JA, Hanauer SB, et al. Ciprofloxacin for the prevention of postoperative recurrence in patients with Crohn’s disease: a randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis. 2013;19:1073–9.

  72. Burnham WR, Lennard-Jones JE, Stanford JL, Bird RG. Mycobacteria as a possible cause of inflammatory bowel disease. Lancet. 1978;2  Pt 1:693–6.

  73. Sanderson JD, Moss MT, Tizard ML, Hermon-Taylor J. Mycobacterium paratuberculosis DNA in Crohn’s disease tissue. Gut. 1992;33:890–6.

  74. Borgaonkar MR, MacIntosh DG, Fardy JM. A meta-analysis of antimycobacterial therapy for Crohn’s disease. Am J Gastroenterol. 2000;95:725–9.

  75. Patton PH, Parker CE, MacDonald JK, Chande N. Anti-tuberculous therapy for maintenance of remission in Crohn’s disease. Cochrane Database Syst Rev. 2016;7:CD000299.

  76. Selby W, Pavli P, Crotty B, et al. Two-year combination antibiotic therapy with clarithromycin, rifabutin, and clofazimine for Crohn’s disease. Gastroenterology. 2007;132:2313–9.

  77. Goodgame RW, Kimball K, Akram S, et al. Randomized controlled trial of clarithromycin and ethambutol in the treatment of Crohn’s disease. Aliment Pharmacol Ther. 2001;15:1861–6.

  78. Swift GL, Srivastava ED, Stone R, et al. Controlled trial of anti-tuberculous chemotherapy for two years in Crohn’s disease. Gut. 1994;35:363–8.

  79. Prantera C, Kohn A, Mangiarotti R, Andreoli A, Luzi C. Antimycobacterial therapy in Crohn’s disease: results of a controlled, double-blind trial with a multiple antibiotic regimen. Am J Gastroenterol. 1994;89:513–8.

  80. Afdhal NH, Long A, Lennon J, Crowe J, O’Donoghue DP. Controlled trial of antimycobacterial therapy in Crohn’s disease. Clofazimine versus placebo. Dig Dis Sci. 1991;36:449–53.

  81. Shaffer JL, Hughes S, Linaker BD, Baker RD, Turnberg LA. Controlled trial of rifampicin and ethambutol in Crohn’s disease. Gut. 1984;25:203–5.

  82. Elliott PR, Burnham WR, Berghouse LM, Lennard-Jones JE, Langman MJ. Sulphadoxine-pyrimethamine therapy in Crohn’s disease. Digestion. 1982;23:132–4.

  83. Basilisco G, Ranzi T, Campanini MC, Piodi L, Bianchi PA. Controlled trial of rifabutin in Crohn’s disease. Curr Ther Res. 1989;46:245–50.

    Google Scholar 

  84. Graham DY, Naser SA, Offman E, et al. 643 RHB-104, a fixed-dose, oral antibiotic combination against mycobacterium avium paratuberculosis (MAP) infection, is effective in moderately to severely active Crohn’s disease. Am J Gastroenterol. 2019;114:S376–7.

  85. Gupta A, Pratap Mouli V, Mohta S, et al. Antitubercular therapy given to differentiate Crohn’s disease from intestinal tuberculosis predisposes to stricture formation. J Crohns Colitis. 2020;14:1611–8.

  86. Liu F, Tang J, Ye L, et al. Prophylactic antitubercular therapy is associated with accelerated disease progression in patients with Crohn’s disease receiving anti-TNF therapy: a retrospective multicenter study. Clin Transl Gastroenterol. 2022;13:e00493.

  87. Sharma V, Mandavdhare HS, Lamoria S, Singh H, Kumar A. Serial C-reactive protein measurements in patients treated for suspected abdominal tuberculosis. Dig Liver Dis. 2018;50:559–62.

  88. Sharma V, Verma S, Kumar-M P, et al. Serial measurements of faecal calprotectin may discriminate intestinal tuberculosis and Crohn’s disease in patients started on antitubercular therapy. Eur J Gastroenterol Hepatol. 2021;33:334–8.

  89. Sharma V, Mandavdhare HS, Dutta U. Letter: Mucosal response in discriminating intestinal tuberculosis from Crohn’s disease-when to look for it?. Aliment Pharmacol Ther. 2018;47:859–60.

  90. Darfeuille-Michaud A, Neut C, Barnich N, et al. Presence of adherent Escherichia coli strains in ileal mucosa of patients with Crohn’s disease. Gastroenterology. 1998;115:1405–13.

  91. Barnich N, Darfeuille-Michaud A. Adherent-invasive Escherichia coli and Crohn’s disease. Curr Opin Gastroenterol. 2007;23:16–20.

  92. Munita JM, Arias CA. Mechanisms of antibiotic resistance. Microbiol Spectr. 2016;4. https://doi.org/10.1128/microbiolspec.VMBF-0016-2015.

  93. Shen B, Kochhar GS, Rubin DT, et al. Treatment of pouchitis, Crohn’s disease, cuffitis, and other inflammatory disorders of the pouch: consensus guidelines from the International Ileal Pouch Consortium. Lancet Gastroenterol Hepatol. 2022;7:69–95.

  94. Barnes EL, Desai A, Kochhar GS. The comparative effectiveness of ciprofloxacin and metronidazole for an initial episode of pouchitis: a propensity-matched study. Am J Gastroenterol. 2023;118:1989–96.

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  1. Indian Navy, Visakhapatnam, 530 014, India

    Daya K. Jha

  2. Liver and Gastro Hospital, Kanpur, 208 002, India

    Shubhra Mishra

  3. Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, 160 012, India

    Usha Dutta & Vishal Sharma

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Conception: UD and VS; initial draft: DKJ and SM; literature review: DKJ, SM and VS; manuscript revisions: UD and VS; final approval: all authors.

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Jha, D.K., Mishra, S., Dutta, U. et al. Antibiotics for inflammatory bowel disease: Current status. Indian J Gastroenterol 43, 145–159 (2024). https://doi.org/10.1007/s12664-024-01537-x

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