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Antibiotic treatment in Crohn's and ulcerative colitis

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • antibacterials, such as metronidazole and ciprofloxacin, may be prescribed in the treatment of fistulating Crohn's Disease to treat accompanying abscesses or in perianal Crohn's Disease or sepsis (1)
  • antibiotics, including metronidazole, are indicated in
    • the treatment of symptoms attributable bacterial overgrowth
    • septic complications
    • perineal disease (3)
  • significant side-effects of metronidazole include peripheral neuropathy if used long term (over three months), a bad taste in the mouth and a disulfiram-like interaction with alcohol

  • antibiotics such as ciprofloxacin have also been used in the place of steroids to treat moderate relapses of ulcerative colitis

NICE suggest (4):

  • to maintain remission in people with ileocolonic Crohn's disease who have had complete macroscopic resection within the last 3 months, consider azathioprine in combination with up to 3 months' postoperative metronidazole


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