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Canadian Journal of Gastroenterology
Volume 20, Issue 10, Pages 651-655

Antibiotic Therapy for Crohn’s Disease: A Review

Simon Lal and A Hillary Steinhart

Inflammatory Bowel Disease Centre, Mount Sinai Hospital, Toronto, Ontario, Canada

Received 20 December 2005; Accepted 31 January 2006

Copyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Increasing evidence suggests that gut bacteria play a pathogenic role in Crohn’s disease (CD), providing a rationale for the use of antibiotics in the primary treatment of the disease. While there are data to suggest that antibiotics may be effective in treating active luminal, particularly colonic, and/or perianal CD, evidence for their use in these settings is hampered by the lack of well-designed, adequately powered, placebo-controlled trials. Furthermore, although nitroimidazole antibiotics have been shown to reduce postoperative recurrence following ileocolonic resection, their use is limited by side effects. There is a current need for rigorous multicentre studies looking into the role of antibiotics in treating perianal and luminal CD, as well as a need for the large-scale assessment of novel antibiotics, with low systemic absorption, which may improve patient tolerance.