Antibiotics

What are antibiotics?

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

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


Back to top

How do antibiotics work?

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.

Back to top

Who are antibiotics used for?

Antibiotics are used to treat and prevent infections by bacteria. They work by killing bacteria in the body or by stopping them from growing, multiplying, and spreading.

Antibiotics are not typically prescribed to people with mild infections because it is assumed that the immune system will clear up any bacteria on its own. However, when the immune system cannot fight off the bacteria on its own, then antibiotics are prescribed to help with this process. 

Antibiotics are used to treat complications of IBD, e.g., abscesses, perianal fistulas, and pouchitis.


Back to top

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.


Back to top

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).


Back to top


In This Section

Back to IBD Journey