Antibiotics

Antibiotics do not counteract inflammation directly, but decrease infection that can cause and result from severe inflammation. Examples include Ciprofloxacin and Metronidazole.

What are antibiotics?

Antibiotics can kill or stop the growth of bacteria in your gut. They can alter your gut microbiome (balance of bacteria in your gut). By killing certain bacteria that are thought to have a role in IBD, such as Mycobacteria, Listeria, and Escherichia coli, antibiotics can help to reduce the recurrence of IBD.

Examples of antibiotics used to treat IBD include metronidazole and ciprofloxacin. These are available as oral medications or injections.


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How effective are antibiotics?

Here is a quick summary how effective antibiotics are in managing IBD:

  • Antibiotics are effective at inducing remission in active Ulcerative Colitis (UC) but no particular class of antibiotic is recommended.

  • There was no data on whether antibiotics are effective at preventing relapse in inactive UC.

  • Antibiotics are effective at inducing remission in active Crohn's Disease (CD) but no particular class of antibiotic is recommended.

  • Antibiotics are effective at reducing fistula drainage in CD.

  • Antibiotics are effective at preventing relapse in inactive CD but no particular class of antibiotic is recommended.


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Side effects and risks of use

Common side effects of antibiotics include nausea, vomiting, diarrhea, and the possibility of developing a Clostridium difficile infection. Women can also experience yeast infections.

In addition to the above, metronidazole is also associated with constipation. Some people complain of a metallic taste in their mouth. If you use it long-term, metronidazole can lead to numbness in the hands or feet, resulting in difficulties with balance. Drinking alcohol while taking metronidazole can cause nausea, vomiting, flushing, and weakness.

The nausea and diarrhea associated with ciprofloxacin is rare and usually short-term. Ciprofloxacin prolongs the effects of caffeine and can cause insomnia and vivid dreams. There are occasional reports of tendonitis (inflammation of the tendons).


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