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Table of Contents
Vol. 73, Suppl. 1, 2006
Issue release date: February 2006
Section title: Paper
Digestion 2006;73:77–85
(DOI:10.1159/000089782)

Antimicrobials in the Management of Inflammatory Bowel Disease

Gionchetti P. · Rizzello F. · Lammers K.M. · Morselli C. · Tambasco R. · Campieri M.
Department of Internal Medicine and Gastroenterology, University of Bologna, Bologna, Italy

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Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: February 27, 2006
Issue release date: February 2006

Number of Print Pages: 9
Number of Figures: 5
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG

Abstract

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 (CD). 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 CD.

© 2006 S. Karger AG, Basel



 

Note Added in Proof


After submission of this paper some authors reported at the meeting of the American College of Gastroenterology in Honolulu (Hawaii, USA) their experience with rifaximin in IBD. The steroid-sparing activity of this poorly absorbed antibiotic was confirmed not only in CD [59, 60] but also in UC [60]. The drug proved to be effec tive – as an add-on medication – in patients with mild to moderately active CD with 75% of them achieving a complete (67%) or partial (33%) response in a median time of 21 (14–30) days [61]. Of those who did not respond to antibiotic treatment, the majority had ileocolic CD.


Article / Publication Details

First-Page Preview
Abstract of Paper

Published online: February 27, 2006
Issue release date: February 2006

Number of Print Pages: 9
Number of Figures: 5
Number of Tables: 2

ISSN: 0012-2823 (Print)
eISSN: 1421-9867 (Online)

For additional information: http://www.karger.com/DIG


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Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher or, in the case of photocopying, direct payment of a specified fee to the Copyright Clearance Center.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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