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Review article: antibiotics and probiotics in inflammatory bowel disease.
Aliment Pharmacol Ther. 2004 Oct; 20 Suppl 4:75-8.AP

Abstract

Treatment with antibiotics in inflammatory bowel disease has a long tradition and is widely used. The indications for antibiotic therapy are wide ranging, from specific situations such as abscesses or fistulae, to patients with severe disease (as an unspecific 'protective' measure), and to address the hypothesis that the enteric flora as a whole, or specific microorganisms such as mycobacteria, are involved in the pathogenesis of inflammatory bowel disease. The best-studied single antibiotic compound is metronidazole. However, overall, the scientific basis for the use of antibiotics is limited, which may reflect a lack of interest from sponsors within the pharmaceutical industry. Despite this weak evidence base, antibiotics are a globally established therapeutic tool in inflammatory bowel disease. Growing evidence from human and animal studies points towards a pivotal pathogenetic role of intestinal bacteria in inflammatory bowel disease. In view of these experimental findings, clinical trials have been undertaken to elucidate the therapeutic effects of probiotics in inflammatory bowel disease. Probiotics are viable nonpathogenic microorganisms which confer health benefits to the host by improving the microbial balance of the indigenous microflora. So far, of the many candidates, one specific strain (Escherichia coli Nissle 1917) and a mixture of eight different bacteria have demonstrated convincing therapeutic efficacy in controlled studies. Maintenance therapy in ulcerative colitis and prevention therapy, as well as the treatment of pouchitis, have emerged as areas in which probiotic therapy offers a valid therapeutic alternative to current treatments. Further investigations may detect additional clinically effective probiotics and other clinical indications.

Authors+Show Affiliations

Evangelisches Krankenhaus Kalk, Teaching Hospital for the University of Cologne, Germany. ansorg@evkk.de

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

15352898

Citation

Kruis, W. "Review Article: Antibiotics and Probiotics in Inflammatory Bowel Disease." Alimentary Pharmacology & Therapeutics, vol. 20 Suppl 4, 2004, pp. 75-8.
Kruis W. Review article: antibiotics and probiotics in inflammatory bowel disease. Aliment Pharmacol Ther. 2004;20 Suppl 4:75-8.
Kruis, W. (2004). Review article: antibiotics and probiotics in inflammatory bowel disease. Alimentary Pharmacology & Therapeutics, 20 Suppl 4, 75-8.
Kruis W. Review Article: Antibiotics and Probiotics in Inflammatory Bowel Disease. Aliment Pharmacol Ther. 2004;20 Suppl 4:75-8. PubMed PMID: 15352898.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Review article: antibiotics and probiotics in inflammatory bowel disease. A1 - Kruis,W, PY - 2004/9/9/pubmed PY - 2005/10/1/medline PY - 2004/9/9/entrez SP - 75 EP - 8 JF - Alimentary pharmacology & therapeutics JO - Aliment. Pharmacol. Ther. VL - 20 Suppl 4 N2 - Treatment with antibiotics in inflammatory bowel disease has a long tradition and is widely used. The indications for antibiotic therapy are wide ranging, from specific situations such as abscesses or fistulae, to patients with severe disease (as an unspecific 'protective' measure), and to address the hypothesis that the enteric flora as a whole, or specific microorganisms such as mycobacteria, are involved in the pathogenesis of inflammatory bowel disease. The best-studied single antibiotic compound is metronidazole. However, overall, the scientific basis for the use of antibiotics is limited, which may reflect a lack of interest from sponsors within the pharmaceutical industry. Despite this weak evidence base, antibiotics are a globally established therapeutic tool in inflammatory bowel disease. Growing evidence from human and animal studies points towards a pivotal pathogenetic role of intestinal bacteria in inflammatory bowel disease. In view of these experimental findings, clinical trials have been undertaken to elucidate the therapeutic effects of probiotics in inflammatory bowel disease. Probiotics are viable nonpathogenic microorganisms which confer health benefits to the host by improving the microbial balance of the indigenous microflora. So far, of the many candidates, one specific strain (Escherichia coli Nissle 1917) and a mixture of eight different bacteria have demonstrated convincing therapeutic efficacy in controlled studies. Maintenance therapy in ulcerative colitis and prevention therapy, as well as the treatment of pouchitis, have emerged as areas in which probiotic therapy offers a valid therapeutic alternative to current treatments. Further investigations may detect additional clinically effective probiotics and other clinical indications. SN - 0269-2813 UR - https://www.unboundmedicine.com/medline/citation/15352898/Review_article:_antibiotics_and_probiotics_in_inflammatory_bowel_disease_ L2 - https://doi.org/10.1111/j.1365-2036.2004.02051.x DB - PRIME DP - Unbound Medicine ER -