Antimicrobials in the management of inflammatory bowel disease

被引:24
作者
Gionchetti, P [1 ]
Rizzello, F [1 ]
Lammers, KM [1 ]
Morselli, C [1 ]
Tambasco, R [1 ]
Campieri, M [1 ]
机构
[1] Univ Bologna, Dept Internal Med & Gastroenterol, Bologna, Italy
关键词
intestinal microflora; antimicrobial agents; antibiotics; rifaximin; Crohn's disease; ulcerative colitis; pouchitis;
D O I
10.1159/000089782
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
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 (CID). 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 CID.
引用
收藏
页码:77 / 85
页数:9
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