EFFECTIVENESS OF ANTIBIOTICS AS A TREATMENT OPTION FOR PATIENTS WITH CROHN’S DISEASE: A META ANALYSIS

Abstract Crohn’s Disease (CD) is an Inflammatory Bowel Disease (IBD) whose etiology has been suspected to include bacterial antigens. A treatment option, therefore, would be the usage of antibiotics. To that end, the purpose of this study was to perform a meta-analysis on the ability of antibiotics inducing remission or a favorable clinical response in Crohn’s disease (CD) patients. Thirty-two randomized, double-blind, placebo-controlled trials of antibiotics for treatment of CD in adults, totaling 3269 patients, were reviewed. Log-odds ratio and probability difference were performed to estimate risk difference. The Number Needed to Treat (NNT) was also calculated for each antibiotic reviewed (rifaximin, metronidazole, clarithromycin, and ciprofloxacin). The analysis revealed that antibiotics greatly improved patients’ Crohn’s disease activity, with a total response (defined as clinical response plus remission) odds ratio of 0.715 (95% CI: 0.6319–0.7971), a clinical response odds-ratio of 0.7478 (95% CI: 0.6214–0.8715), and a remission odds-ratio of 0.6877 (95% CI: 0.5768–0.7987). The Number Needed to Treat for each of the antibiotics used in the clinical trials were 5.018 (Ciprofloxacin), 6.480 (Clarithromycin), 7.556 (Metronidazole), and 6.824 (Rifaximin). This is an important outcome because it not only opens up a new treatment option for those suffering from Crohn’s Disease but it also leads credibility to the theory that Crohn’s is caused, at least in part, by bacteria, such as Mycobacterium avium subspecies paratuberculosis and adherent invasive E. coli.