What influence do antibiotics have on the healing of a relapse?
Antibiotics are not part of the standard therapy for an acute relapse of Crohn’s disease, as it has not yet been proven that they increase the probability of remission (improvement of symptoms). Nevertheless, many patients in relapses are treated with antibiotics, especially metronidazole and ciprofloxacin. This is because it has been shown that these two agents can reduce disease activity in relapses by just under 30% (placebo only by about 1%).
Thus, they appear to be similarly effective as the proven active ingredient 5-ASA (mesalazine, sulfasalazine). Another indication for antibiotics in relapses is bacterial inflammation of abscesses or fistulas in the anal region. These can be effectively treated with the two active ingredients already mentioned.
However, antibiotics are not suitable for maintaining remission in long-term therapy. For example, metronidazole can cause nerve damage to the extremities after prolonged use, while ciprofloxacin can damage the tendons, among other things. The role of antibiotics in the treatment of Crohn’s disease could also increase in the future, as some researchers attribute a role in the development of the disease to the bacterium “Mycobacterium avium sebspecies paratuberculosis”. Studies on the efficacy of specific antibiotic therapies against this pathogen are currently still ongoing.
