Gut microbiota and inflammatory bowel disease: The role of antibiotics in disease management

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21 Scopus citations

Abstract

Imbalances in the composition and number of bacteria in the gut microbiota have been implicated in inflammatory bowel disease (IBD), and modulation of the gut microbiota by probiotics and antibiotics in IBD has been an active area of research, with mixed results. This narrative review summarizes the findings of relevant publications identified using the PubMed database. Although antibiotics have been associated with an increased risk of IBD development and flares, several meta-analyses demonstrate that antibiotics are efficacious for the induction of remission and treatment of flares in patients with IBD. Data supporting their use include a large number of antibiotic studies in Crohn's disease and evidence suggests antibiotics are efficacious in both Crohn's disease and ulcerative colitis, although there are fewer studies of the latter. For Crohn's disease, antibiotics have been shown to be useful for the induction of remission and in the postoperative management of patients undergoing surgery. Additionally, patients with fistulizing disease, particularly perianal, can benefit from antibiotics administered short term. Both antimicrobials and probiotics have been shown to be useful for the treatment of pouchitis. Additional randomized controlled trials are needed to further elucidate the role of bacteria in IBD and to better inform clinicians about appropriate antibiotic therapies.

Original languageEnglish (US)
Pages (from-to)7-19
Number of pages13
JournalPostgraduate medicine
Volume126
Issue number4
DOIs
StatePublished - Jan 1 2014

Keywords

  • Antibiotics
  • Crohn’s disease
  • Inflammatory bowel disease
  • Probiotics
  • Ulcerative colitis

ASJC Scopus subject areas

  • Medicine(all)

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