Gut microbiota and inflammatory bowel disease: the role of antibiotics in disease management
Abstract
Imbalances in the composition and number of bacteria in the gut microbiota have been implicated in inflammatory bowel disease (IBD), and modulation of the gut microbiota by probiotics and antibiotics in IBD has been an active area of research, with mixed results. This narrative review summarizes the findings of relevant publications identified using the PubMed database. Although antibiotics have been associated with an increased risk of IBD development and flares, several meta-analyses demonstrate that antibiotics are efficacious for the induction of remission and treatment of flares in patients with IBD. Data supporting their use include a large number of antibiotic studies in Crohn's disease and evidence suggests antibiotics are efficacious in both Crohn's disease and ulcerative colitis, although there are fewer studies of the latter. For Crohn's disease, antibiotics have been shown to be useful for the induction of remission and in the postoperative management of patients undergoing surgery. Additionally, patients with fistulizing disease, particularly perianal, can benefit from antibiotics administered short term. Both antimicrobials and probiotics have been shown to be useful for the treatment of pouchitis. Additional randomized controlled trials are needed to further elucidate the role of bacteria in IBD and to better inform clinicians about appropriate antibiotic therapies.
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Several meta-analyses have revealed that antibiotics are effective in inducing remission and treating flares in patients with IBD.
“Although exposure to antibiotics is considered to be a potential risk factor for IBD (11, 128, 129), several meta-analyses have revealed that antibiotics are effective in inducing remission and treating flares in patients with IBD (130, 131).”
From Stress triggers flare of inflammatory bowel disease in children and adults (2019) · cites this paper as [130]
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- Authors
- Kerman, D. H., & Deshpande, A. R.
- Affiliations
- University of Miami (US)
- Corresponding author
- Kerman, David H.
- ORCID
- Deshpande, Amar R.
- Venue
- Postgraduate Medicine
- Publisher
- Informa UK Limited
- Published
- 2014-07
- Volume
- 126
- Issue
- 4
- Pages
- 7-19
- ISSN
- 0032-5481 (ISSN-L)
- 1941-9260
- OpenAlex
- W2116012654
- Cited by
- 47
- References
- 105
- Citations by year
- 2026: 2 · 2025: 1 · 2024: 10 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 3 · 2019: 5 · 2018: 5 · 2017: 4 · 2016: 10 · 2015: 2
- FWCI
- 0.71
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Postgraduate Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Life Sciences › Agricultural and Biological Sciences › Food Science › Probiotics and Fermented Foods
- Keywords
- gut microbiota, inflammatory bowel disease, antibiotics, Crohn's disease, ulcerative colitis, probiotics, remission induction, disease flares, postoperative care, anal fistula, pouchitis, IBD risk
- MeSH terms
- Animals, Anti-Bacterial Agents, Colitis, Ulcerative, Crohn Disease, Humans, Intestines, Rectal Fistula, Remission Induction, Inflammatory Bowel Diseases, Probiotics, Microbiota
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