A Controlled Trial Comparing Ciprofloxacin With Mesalazine for The Treatment of Active Crohn's Disease

Jf, Colombel; Lémann, Marc; Cassagnou, Michel; Bouhnik, Yoram; Duclos, Bernard; Jl, Dupas; Notteghem, B; Jy, Mary

doi:10.1111/j.1572-0241.1999.935_q.x

Cited by 216 publications

(24 citation statements)

References 21 publications

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“…Several randomized clinical trials have evaluated the efficacy of these antibiotics, used alone or in combination, at inducing remission in CD (table 2) [35,37,38,39,40,41,42]. The results of these studies have shown that patients with colonic localization get more benefit from antibiotics, probably because of the higher bacterial concentration in the colon than in the small bowel.…”

Section: Antibiotics As a Treatment Of Inflammatory Bowel Diseasementioning

confidence: 99%

Antibiotics and Inflammatory Bowel Diseases

Scribano

Prantera²

2013

Dig Dis

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Inflammatory bowel diseases are characterized by an altered composition of gut microbiota (dysbiosis) that may contribute to their development. Antibiotics can alter the bacterial flora, and a link between antibiotic use and onset of Crohn's disease (CD), but not ulcerative colitis, has been reported. The hypothesis that Mycobacterium avium subspecies paratuberculosis (MAP) could be an etiologic agent of CD has not been confirmed by a large study on patients treated by an association of antibiotics active against MAP. The observations supporting a role of intestinal microbiota in CD pathogenesis provide the rationale for a therapeutic manipulation of the intestinal flora through the employment of antibiotics. However, current data do not strongly support a therapeutic benefit from antibiotics, and there is still controversy regarding their use as primary therapy for treatment of acute flares of CD, and for postoperative recurrence prevention. Nevertheless, clinical practice and some studies suggest that a subgroup of patients with colonic involvement, early disease, and abnormal laboratory test of inflammation may respond better to antibiotic treatment. Since their long-term use is frequently complicated by a high rate of side effects, the use of antibiotics that work locally appears to be promising.

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Section: Antibiotics As a Treatment Of Inflammatory Bowel Diseasementioning

confidence: 99%

Antibiotics and Inflammatory Bowel Diseases

Scribano

Prantera²

2013

Dig Dis

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“…Again, subgroup analysis suggested a benefit of antibiotic therapy in patients with colonic involvement (53% remission in the antibiotics group vs. 25% in the placebo group, p = 0.10). Two additional studies showed no difference between ciprofloxacin and mesalazine [42], and between ciprofloxacin plus metronidazole and 6-methylprednisolone [43]. Due to the small sample size, there is a high risk of type II errors in these studies that did not have a design adequate for equivalence studies.…”

Section: First-line Treatment Optionsmentioning

confidence: 99%

Mild-to-Moderate Active Luminal Crohn’s Disease

Michetti

Juillerat²,

Mottet³

et al. 2007

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The management of luminal Crohn’s disease, the most common form of initial presentation of the disease, depends on the location and the severity of the disease. Mild-to-moderate disease represents a relatively large proportion of patients with a first flare of luminal disease, which may also be associated with perianal disease. As quality of life of these patients inversely correlates with disease activity, adequate therapy is a central goal of the overall patient management. Treatment options include mainly sulfasalazine, budesonide and systemic steroids, while the role of mesalazine and antibiotics remains controversial. The role of biological therapies has not been thoroughly evaluated in patients with mild disease.

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“…After 6 weeks, both treatments were equally effective, the remission rate being 56 and 55% in patients receiving ciprofloxacin or mesalamine respectively [36]. In a small study [37], ciprofloxacin was shown to be effective in association to standard treatment in patients with resistant disease.…”

Section: Studies In Patients With Crohn’s Diseasementioning

confidence: 99%

Antimicrobials in the Management of Inflammatory Bowel Disease

Gionchetti

Rizzello²,

Lammers³

et al. 2006

Digestion

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Many experimental and clinical observations suggest a potential role for intestinal microflora in the pathogenesis of inflammatory bowel disease (IBD). Manipulation of the luminal content using antibiotics may therefore represent a potentially effective therapeutic option. However, the available studies do not support the use of antimicrobials in ulcerative colitis and larger studies are required. These drugs are however effective in treating septic complications of Crohn’s disease (CD). The use of antibacterial agents as primary therapy for CD is more controversial, although this approach is frequently and successfully adopted in clinical practice. Despite the fact that properly controlled trials have been not carried out, antimicrobials are the mainstay of the treatment of pouchitis. Rifaximin is a poorly absorbed, broad-spectrum antibiotic that, thanks to its efficacy and long-term safety, could represent the preferred tool of manipulating enteric flora in patients with IBD. Preliminary data suggest that rifaximin may be beneficial in the treatment of active ulcerative colitis (and pouchitis), mild to moderate CD as well as prevention of post-operative recurrence of CD.

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A Controlled Trial Comparing Ciprofloxacin With Mesalazine for The Treatment of Active Crohn's Disease

Abstract: This study suggests that ciprofloxacin 1 g/day is as effective as mesalazine 4 g/day in treating mild to moderate flare-up of Crohn's disease.

Cited by 216 publications

References 21 publications

Antibiotics and Inflammatory Bowel Diseases

Antibiotics and Inflammatory Bowel Diseases

Mild-to-Moderate Active Luminal Crohn’s Disease

Antimicrobials in the Management of Inflammatory Bowel Disease

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