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The role of antibiotics in Crohn's disease

J R Cangemi1

  • 1Mayo Clinic Jacksonville, Jacksonville, Fla. 32224, USA.

Digestive Diseases (Basel, Switzerland)
|August 7, 1999
PubMed

Insights

Antibiotics are frequently used for Crohn's disease, but evidence is limited. This review explores the potential infectious origins and role of gut permeability in Crohn's disease, examining antibiotic efficacy.

Area of Science:

  • Gastroenterology and Infectious Diseases
  • Microbiome Research

Background:

  • Crohn's disease (CD) management often includes antibiotics, despite limited controlled trial data.
  • Histological findings suggest an infectious etiology in CD, with increased infectious complications observed in patients.
  • Increased intestinal permeability may allow enteric organisms or their components to reach the mucosa.

Purpose of the Study:

  • To critically review the existing literature on the role of antibiotics in Crohn's disease.
  • To explore the potential infectious origins and pathophysiology of Crohn's disease.
  • To understand the influence of the fecal stream on antibiotic efficacy in CD.

Main Methods:

  • Literature review focusing on histology, histopathology, and infectious complications in Crohn's disease.
  • Analysis of studies investigating intestinal permeability and its relation to enteric organisms.
  • Critical evaluation of clinical data regarding antibiotic use in Crohn's disease management.

Main Results:

  • Histology and histopathology support an infectious component in Crohn's disease.
  • Patients with Crohn's disease exhibit a higher incidence of infectious complications.
  • Enhanced intestinal permeability is implicated in the pathogenesis, facilitating microbial access.

Conclusions:

  • The role of antibiotics in Crohn's disease requires further investigation, considering potential infectious origins.
  • Understanding the pathophysiology, including gut permeability and fecal stream dynamics, is crucial for optimizing CD treatment.
  • More controlled data are needed to establish definitive guidelines for antibiotic use in Crohn's disease.

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