亲爱的研友该休息了!由于当前在线用户较少,发布求助请尽量完整地填写文献信息,科研通机器人24小时在线,伴您度过漫漫科研夜!身体可是革命的本钱,早点休息,好梦!

Antibiotic Therapy in Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

医学 炎症性肠病 荟萃分析 抗生素治疗 抗生素 疾病 炎症性肠病 重症监护医学 梅德林 系统回顾 内科学 微生物学 生物 政治学 法学
作者
Khurram J. Khan,Thomas Ullman,Alexander C. Ford,María T. Abreu,Amir Abadir,John K. Marshall,Nicholas J. Talley,Paul Martin
出处
期刊:The American Journal of Gastroenterology [Lippincott Williams & Wilkins]
卷期号:106 (4): 661-673 被引量:482
标识
DOI:10.1038/ajg.2011.72
摘要

The etiology of inflammatory bowel disease (IBD) is unknown but may relate to an unidentified bacterial pathogen or an immunological reaction to gut microbiota. Antibiotics have therefore been proposed as a therapy for Crohn's disease (CD) and ulcerative colitis (UC) to induce remission in active disease to prevent relapse. Current data are conflicting and we therefore conducted a systematic review of randomized controlled trials (RCTs) evaluating antibiotics in IBD. Only parallel group RCTs were considered eligible. Studies with adult patients receiving any dose of therapy for at least 7 days and up to 16 weeks for active disease, or at least 6 months of follow-up for preventing relapse in quiescent disease were analyzed. We included any antibiotics alone or in combination using predefined definitions of remission and relapse. Two reviewers independently assessed eligibility and extracted data. The primary outcome was remission or relapse using an intention-to-treat methodology. The data were summarized using relative risk (RR) and pooled using a random effects model. For active CD, there were 10 RCTs involving 1,160 patients. There was a statistically significant effect of antibiotics being superior to placebo (RR of active CD not in remission=0.85; 95% confidence interval (CI)=0.73-0.99, P=0.03). There was moderate heterogeneity between results (I(2)=48%) and a diverse number of antibiotics were tested (anti-tuberculosis therapy, macrolides, fluroquinolones, 5-nitroimidazoles, and rifaximin) either alone or in combination. Rifamycin derivatives either alone or in combination with other antibiotics appeared to have a significant effect at inducing remission in active CD. In perianal CD fistula there were three trials evaluating 123 patients using either ciprofloxacin or metronidazole. There was a statistically significant effect in reducing fistula drainage (RR=0.8; 95% CI=0.66-0.98) with no heterogeneity (I(2)=0%) and an number needed to treat 5 (95% CI=3-20). For quiescent CD, there were 3 RCTs involving 186 patients treated with different antibiotics combinations (all including antimycobacterials) vs. placebo. There was a statistically significant effect in favor of antibiotics vs. placebo (RR of relapse=0.62; 95% CI=0.46-0.84), with no heterogeneity (I(2)=0%). In active UC, there were 9 RCTs with 662 patients and there was a statistically significant benefit for antibiotics inducing remission (RR of UC not in remission=0.64; 95% CI=0.43-0.96). There was moderate heterogeneity (I(2)=69%) and antibiotics used were all different single or combination drugs. Antibiotic therapy may induce remission in active CD and UC, although the diverse number of antibiotics tested means the data are difficult to interpret. This systematic review is a mandate for further trials of antibiotic therapy in IBD.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
fufufu123完成签到 ,获得积分10
3秒前
桐桐应助科研通管家采纳,获得10
19秒前
puzhongjiMiQ完成签到,获得积分10
36秒前
1分钟前
李健的粉丝团团长应助lzzz采纳,获得10
1分钟前
1分钟前
刘紫媛发布了新的文献求助10
1分钟前
Raul完成签到 ,获得积分10
2分钟前
lql完成签到 ,获得积分10
2分钟前
可爱的函函应助鲅鱼圈采纳,获得10
3分钟前
3分钟前
lzzz发布了新的文献求助10
3分钟前
英喆完成签到 ,获得积分10
3分钟前
我是老大应助畅快的毛衣采纳,获得10
3分钟前
4分钟前
4分钟前
鲅鱼圈发布了新的文献求助10
4分钟前
4分钟前
Leofar完成签到 ,获得积分10
4分钟前
4分钟前
鲅鱼圈完成签到,获得积分10
4分钟前
h0jian09完成签到,获得积分10
4分钟前
BaooooooMao完成签到,获得积分10
5分钟前
愉快的犀牛完成签到 ,获得积分10
5分钟前
Sunny完成签到,获得积分10
5分钟前
yujie完成签到 ,获得积分10
5分钟前
赘婿应助科研通管家采纳,获得10
6分钟前
6分钟前
西柚柠檬完成签到 ,获得积分10
6分钟前
心系天下完成签到 ,获得积分10
6分钟前
Alex-Song完成签到 ,获得积分0
6分钟前
不秃燃的小老弟完成签到 ,获得积分10
7分钟前
8分钟前
Owen应助科研通管家采纳,获得10
8分钟前
年年有余完成签到,获得积分10
8分钟前
胖小羊完成签到 ,获得积分10
9分钟前
10分钟前
领导范儿应助科研通管家采纳,获得10
10分钟前
10分钟前
juan完成签到 ,获得积分10
11分钟前
高分求助中
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
A new approach to the extrapolation of accelerated life test data 1000
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
基于可调谐半导体激光吸收光谱技术泄漏气体检测系统的研究 350
Robot-supported joining of reinforcement textiles with one-sided sewing heads 320
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3990447
求助须知:如何正确求助?哪些是违规求助? 3532166
关于积分的说明 11256513
捐赠科研通 3271046
什么是DOI,文献DOI怎么找? 1805207
邀请新用户注册赠送积分活动 882302
科研通“疑难数据库(出版商)”最低求助积分说明 809234