A meta-analysis of broad-spectrum antibiotic therapy in patients with active Crohn's disease

Abstract

Objective: This meta-analysis of controlled clinical trials was conducted to evaluate whether the use of broad-spectrum antibacterial therapy is associated with improvement in the clinical symptoms of Crohn's disease (CD).

Methods: The MEDLINE and SCOPUS databases were searched from 1966 through May 3, 2006, for clinical trials that evaluated the efficacy of broad-spectrum antibiotics in CD. The search terms were Crohn's disease and antibiotics, antimicrobial, metronidazole, ciprofloxacin, or cotrimoxazole. The reference lists of retrieved articles were reviewed for additional relevant studies. Clinical improvement (response, remission, or improvement in clinical and/or laboratory findings) was the key outcome of interest.

Results: Six randomized, placebo-controlled clinical trials were included in the meta-analysis. Pooling of the results from these trials yielded an odds ratio of 2.257 (95% CI, 1.678-3.036; P < 0.001) for antimicrobial therapy compared with placebo in patients with CD.

Conclusion: The results of this meta-analysis suggest that broad-spectrum antibiotics improve clinical outcomes in patients with CD, although further trials are needed.