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

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.

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  • Authors+Show Affiliations

    ,

    Assistant Professor of Clinical Medicine, Division of Gastroenterology, University of Miami Miller School of Medicine, Miami, FL. dkerman@med.miami.edu.

    Source

    Postgraduate medicine 126:4 2014 Jul pg 7-19

    MeSH

    Animals
    Anti-Bacterial Agents
    Colitis, Ulcerative
    Crohn Disease
    Humans
    Inflammatory Bowel Diseases
    Intestines
    Microbiota
    Probiotics
    Rectal Fistula
    Remission Induction

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't
    Review

    Language

    eng

    PubMed ID

    25141239

    Citation

    Kerman, David H., and Amar R. Deshpande. "Gut Microbiota and Inflammatory Bowel Disease: the Role of Antibiotics in Disease Management." Postgraduate Medicine, vol. 126, no. 4, 2014, pp. 7-19.
    Kerman DH, Deshpande AR. Gut microbiota and inflammatory bowel disease: the role of antibiotics in disease management. Postgrad Med. 2014;126(4):7-19.
    Kerman, D. H., & Deshpande, A. R. (2014). Gut microbiota and inflammatory bowel disease: the role of antibiotics in disease management. Postgraduate Medicine, 126(4), pp. 7-19. doi:10.3810/pgm.2014.07.2779.
    Kerman DH, Deshpande AR. Gut Microbiota and Inflammatory Bowel Disease: the Role of Antibiotics in Disease Management. Postgrad Med. 2014;126(4):7-19. PubMed PMID: 25141239.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Gut microbiota and inflammatory bowel disease: the role of antibiotics in disease management. AU - Kerman,David H, AU - Deshpande,Amar R, PY - 2014/8/21/entrez PY - 2014/8/21/pubmed PY - 2014/10/22/medline SP - 7 EP - 19 JF - Postgraduate medicine JO - Postgrad Med VL - 126 IS - 4 N2 - 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. SN - 1941-9260 UR - https://www.unboundmedicine.com/medline/citation/25141239/Gut_microbiota_and_inflammatory_bowel_disease:_the_role_of_antibiotics_in_disease_management_ L2 - http://www.tandfonline.com/doi/full/10.3810/pgm.2014.07.2779 DB - PRIME DP - Unbound Medicine ER -