Iaquinto, G.; Mazzarella, G.; Sellitto, C.; Lucariello, A.; Melina, R.; Iaquinto, S.; De Luca, A.; Rotondi Aufiero, V. Antibiotic Therapy for Active Crohn’s Disease Targeting Pathogens: An Overview and Update. Antibiotics2024, 13, 151.
Iaquinto, G.; Mazzarella, G.; Sellitto, C.; Lucariello, A.; Melina, R.; Iaquinto, S.; De Luca, A.; Rotondi Aufiero, V. Antibiotic Therapy for Active Crohn’s Disease Targeting Pathogens: An Overview and Update. Antibiotics 2024, 13, 151.
Iaquinto, G.; Mazzarella, G.; Sellitto, C.; Lucariello, A.; Melina, R.; Iaquinto, S.; De Luca, A.; Rotondi Aufiero, V. Antibiotic Therapy for Active Crohn’s Disease Targeting Pathogens: An Overview and Update. Antibiotics2024, 13, 151.
Iaquinto, G.; Mazzarella, G.; Sellitto, C.; Lucariello, A.; Melina, R.; Iaquinto, S.; De Luca, A.; Rotondi Aufiero, V. Antibiotic Therapy for Active Crohn’s Disease Targeting Pathogens: An Overview and Update. Antibiotics 2024, 13, 151.
Abstract
: Crohn’s disease (CD) is a multifactorial chronic disorder that involves a combination of factors as genetic, immune response and gut microbiota. Actually, the therapy comprises salicylates, immunosuppressive agents, corticosteroids, biologic drugs. International guidelines don’t recommend the use of antibiotics except for septic complications of CD patients. The increased evidence of the implication of gut bacteria in this chronic disease support the rationale for using antibiotics as primary treatment of active CD. In the last decades several pathogens have been reported to be involved in the development of CD, but only Escherichia coli (E.coli) species and Mycobacterium avium paratubercolosis (MAP), aroused the interest due to their strong association with CD pathogenesis. Several meta-analyses have been published concerning antibiotic treatment in CD patients but randomized trials of antibiotic treatments against E.coli and MAP did not show prolonged benefits, and only generated conflicting results so much so that several questions are still unresolved regarding trial design, antibiotic dosing, the formulation used, the treatment course and the outcome measures. In this article we attempted to provide an overview and update of the trials on antibiotic treatment in active CD patients taking into account the role of pathogens, the mechanism by which the different antibiotics act on harmful pathogens, and antibiotic resistance. Finally, we also tried to draw new lines for future studies to use antibiotics to treat active CD patients
Medicine and Pharmacology, Gastroenterology and Hepatology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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