Related Experiment Video

Updated: May 11, 2026

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
07:06

Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection

Published on: December 8, 2014

Antibiotic Utilization for Perianal Fistulizing Complications among Young Patients with Crohn's Disease

Samir Gadepalli1, Alison Tribble2, Moshiur Rahman3

  • 1Pediatric Surgery, Michigan Medicine, Ann Arbor, MI; Susan B. Meister Child Health Evaluation and Research Center, Michigan Medicine, Ann Arbor, MI.

The Journal of Pediatrics
|May 9, 2026
PubMed

Insights

Children with Crohn's disease (CD) and perianal fistulizing complications (PFCs) use significantly more antibiotics. This highlights the need for better antibiotic stewardship and evidence-based treatment strategies in pediatric CD management.

Area of Science:

  • Pediatric Gastroenterology
  • Inflammatory Bowel Disease Research
  • Pharmacology and Therapeutics

Background:

  • Crohn's disease (CD) is a chronic inflammatory bowel disease affecting children.
  • Perianal fistulizing complications (PFCs) are a common and challenging manifestation in pediatric CD.
  • Antibiotic use is frequent in managing pediatric CD, but patterns and associations with complications require characterization.

Purpose of the Study:

  • To investigate antibiotic utilization patterns in children diagnosed with Crohn's disease (CD).
  • To determine the association between antibiotic dispensing and the development of perianal fistulizing complications (PFCs) in pediatric CD patients.
  • To analyze predictors of antibiotic use in this specific patient population.

Main Methods:

  • Retrospective analysis of US administrative claims data from 2009-2018.
  • Inclusion of patients aged 21 years or younger with CD and 5 years of continuous enrollment.
  • Evaluation of patient demographics, medication dispensing records, and disease outcomes using multivariable regression models.

Main Results:

  • A cohort of 5,277 pediatric CD patients was analyzed; 17% developed PFCs.
  • Antibiotic prescriptions were common, with 83% of patients receiving at least one.
  • Patients with PFCs exhibited significantly higher antibiotic dispensing (median 67 days) compared to those without PFCs (median 27 days), a 90% increase in adjusted analysis.

Conclusions:

  • Perianal fistulizing complications (PFCs) are prevalent in pediatric Crohn's disease and strongly linked to increased antibiotic use.
  • A substantial proportion of pediatric CD patients with PFCs receive extensive antibiotic prescriptions.
  • The findings underscore the critical need for evidence-based treatment guidelines and robust antibiotic stewardship programs for pediatric CD.
Abstract

Keywords:
Crohn's diseaseabscessantibioticsperianal fistulasurgery

More Related Videos

Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis06:19

Chinese Herbal Retention Enema for the Treatment of Ulcerative Colitis

Published on: May 16, 2025

Related Concept Videos

Inflammatory Bowel Disease V: Surgical Management01:21

Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids01:21

Drugs for Treatment of Crohn's Disease in IBD Using Glucocorticoids

Glucocorticoids, a class of anti-inflammatory drugs, are pivotal in treating moderate to severe Crohn's disease by inducing remission. They exhibit their anti-inflammatory action by inhibiting the production of inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1, and chemokines like IL-8. In addition, they reduce the expression of inflammatory cell adhesion molecules and inhibit gene transcription of nitric oxide synthase, phospholipase A2, cyclooxygenase-2 (COX-2),...
Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents01:29

Drugs for Treatment of Crohn's Disease in IBD Using Immunomodulatory Agents

Crohn's disease is an inflammatory bowel disorder marked by chronic inflammation of the GI tract. Various treatment strategies for Crohn's disease are employed, such as immunomodulatory agents, glucocorticoids, and biologics or anti-TNF therapy. Azathioprine (Imuran), a commonly used immunomodulatory drug for Crohn's disease, is converted in the body to mercaptopurine, which inhibits purine biosynthesis and cell proliferation. Both are utilized in severe cases of Inflammatory Bowel Disease...
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care01:30

Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care

A healthcare provider can diagnose a urinary tract infection (UTI) through several methods:Medical History and Symptoms: The provider will take a detailed medical history and ask about symptoms such as frequent urination, burning sensation during urination, and lower abdominal pain.Urinalysis: A clean-catch urine sample is collected in a sterile container and tested for the presence of bacteria, white blood cells (leukocytes), nitrites, blood, and protein. The presence of leukocytes and...
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF01:24

Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF

Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab (Humira),...
Drugs for Treatment of Ulcerative Colitis in IBD01:29

Drugs for Treatment of Ulcerative Colitis in IBD

Ulcerative colitis is a chronic inflammatory condition primarily affecting the colon and rectum. The primary drugs used in the treatment of ulcerative colitis are aminosalicylates. They exhibit anti-inflammatory and immunosuppressive properties. They modulate inflammatory mediators and inhibit the activity of nuclear factor κB (NF-κB). Aminosalicylates also reduce inflammation by inhibiting prostaglandin and leukotriene production and decreasing neutrophil chemotaxis and superoxide generation.