Meta‑analysis of ciprofloxacin in treatment of Crohn's disease

Wu,Xiao‑Wei; Ji,Hong‑Zan; Wang,Fang‑Yu

doi:10.3892/br.2014.368

Meta‑analysis of ciprofloxacin in treatment of Crohn's disease

Authors:
- Xiao‑Wei Wu
- Hong‑Zan Ji
- Fang‑Yu Wang
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Affiliations: Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu 210002, P.R. China
Published online on: October 1, 2014 https://doi.org/10.3892/br.2014.368
Pages: 70-74

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Abstract

The aim of the present study was to evaluate the efficacy of ciprofloxacin (cipro) for the treatment of Crohn's disease (CD) through a meta‑analysis of randomized controlled trials. The PubMed, Embase and Cochrane Library databases were searched up to May 2014, with no language restrictions, for randomized placebo‑controlled trials. Additional references were obtained from the reviewed studies. Five studies were in accordance with the criteria and were included in the meta‑analysis. The pooled risk ratio (RR) of all the studies was 1.35 [95% confidence interval (CI), 1.03‑1.76; P=0.03]. In three studies, cipro was used for the treatment of CD with perianal fistula and the pooled RR was 1.66 (95% CI, 1.16‑2.39; P=0.006). In two studies, cipro was used to treat active CD and the pooled RR was 1.13 (95% CI, 0.77‑1.66; P=0.54). Thus in conclusion, cipro exhibits a significant efficacy for the treatment of CD, in particular with perianal fistula.

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1	Baumgart DC and Sandborn WJ: Crohn's disease. Lancet. 380:1590–1605. 2012. View Article : Google Scholar
2	Cho JH and Brant SR: Recent insights into the genetics of inflammatory bowel disease. Gastroenterology. 140:1704–1712. 2011. View Article : Google Scholar : PubMed/NCBI
3	Perencevich M and Burakoff R: Use of antibiotics in the treatment of inflammatory bowel disease. Inflamm Bowel Dis. 12:651–664. 2006. View Article : Google Scholar : PubMed/NCBI
4	Sartor RB: Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics. Gastroenterology. 126:1620–1633. 2004. View Article : Google Scholar : PubMed/NCBI
5	Prantera C: What role do antibiotics have in the treatment of IBD? Nat Clin Pract Gastroenterol Hepatol. 5:670–671. 2008. View Article : Google Scholar : PubMed/NCBI
6	Dignass A, Van Assche G, Lindsay JO, et al European Crohn's and Colitis Organisation (ECCO): The second European evidence-based Consensus on the diagnosis and management of Crohn's disease: Current management. J Crohns Colitis. 4:28–62. 2010. View Article : Google Scholar
7	Higgins JP, Altman DG, Gotzsche PC, et al Cochrane Bias Methods Group; Cochrane Statistical Methods Group: The Cochrane Collaboration's tool for assessing risk of bias in randomised trials. BMJ. 343:d59282011. View Article : Google Scholar
8	Higgins JP, Thompson SG, Deeks JJ and Altman DG: Measuring inconsistency in meta-analyses. BMJ. 327:557–560. 2003. View Article : Google Scholar : PubMed/NCBI
9	Egger M, Davey Smith G, Schneider M, et al: Bias in meta-analysis detected by a simple, graphical test. BMJ. 315:629–634. 1997. View Article : Google Scholar : PubMed/NCBI
10	Arnold GL, Beaves MR, Pryjdun VO and Mook WJ: Preliminary study of ciprofloxacin in active Crohn's disease. Inflamm Bowel Dis. 8:10–15. 2002. View Article : Google Scholar : PubMed/NCBI
11	Dewint P, Hansen BE, Verhey E, et al: Adalimumab combined with ciprofloxacin is superior to adalimumab monotherapy in perianal fistula closure in Crohn's disease: a randomised, double-blind, placebo controlled trial (ADAFI). Gut. 63:292–299. 2014.PubMed/NCBI
12	Steinhart AH, Feagan BG, Wong CJ, et al: Combined budesonide and antibiotic therapy for active Crohn's disease: a randomized controlled trial. Gastroenterology. 123:33–40. 2002. View Article : Google Scholar
13	Thia KT, Mahadevan U, Feagan BG, et al: Ciprofloxacin or metronidazole for the treatment of perianal fistulas in patients with Crohn's disease: a randomized, double-blind, placebo-controlled pilot study. Inflamm Bowel Dis. 15:17–24. 2009. View Article : Google Scholar
14	West RL, van der Woude CJ, Hansen BE, et al: Clinical and endosonographic effect of ciprofloxacin on the treatment of perianal fistulae in Crohn's disease with infliximab: a double-blind placebo-controlled study. Aliment Pharmacol Ther. 20:1329–1336. 2004. View Article : Google Scholar : PubMed/NCBI
15	Hammer HF: Gut microbiota and inflammatory bowel disease. Dig Dis. 29:550–553. 2011. View Article : Google Scholar : PubMed/NCBI
16	Chassaing B and Darfeuille-Michaud A: The commensal microbiota and enteropathogens in the pathogenesis of inflammatory bowel diseases. Gastroenterology. 140:1720–1728. 2011. View Article : Google Scholar : PubMed/NCBI
17	Prantera C and Scribano ML: Antibiotics and probiotics in inflammatory bowel disease: why, when, and how. Curr Opin Gastroenterol. 25:329–333. 2009. View Article : Google Scholar : PubMed/NCBI
18	Hooper DC and Wolfson JS: Fluoroquinolone antimicrobial agents. N Engl J Med. 324:384–394. 1991. View Article : Google Scholar : PubMed/NCBI
19	Sanders CC, Sanders WE Jr and Goering RV: Overview of preclinical studies with ciprofloxacin. Am J Med. 82:2–11. 1987. View Article : Google Scholar : PubMed/NCBI
20	Peppercorn MA: Is there a role for antibiotics as primary therapy in Crohn's ileitis? J Clin Gastroenterol. 17:235–237. 1993. View Article : Google Scholar : PubMed/NCBI
21	Prantera C, Berto E, Scribano ML and Falasco G: Use of antibiotics in the treatment of active Crohn's disease: experience with metronidazole and ciprofloxacin. Ital J Gastroenterol Hepatol. 30:602–606. 1998.
22	Greenbloom SL, Steinhart AH and Greenberg GR: Combination ciprofloxacin and metronidazole for active Crohn's disease. Can J Gastroenterol. 12:53–56. 1998.
23	Ishikawa T, Okamura S, Oshimoto H, Kobayashi R and Mori M: Metronidazole plus ciprofloxacin therapy for active Crohn's disease. Intern Med. 42:318–321. 2003. View Article : Google Scholar
24	Colombel JF, Lémann M, Cassagnou M, et al: A controlled trial comparing ciprofloxacin with mesalazine for the treatment of active Crohn's disease. Groupe d'Etudes Therapeutiques des Affections Inflammatoires Digestives (GETAID). Am J Gastroenterol. 94:674–678. 1999. View Article : Google Scholar : PubMed/NCBI
25	Prantera C, Zannoni F, Scribano ML, et al: An antibiotic regimen for the treatment of active Crohn's disease: a randomized, controlled clinical trial of metronidazole plus ciprofloxacin. Am J Gastroenterol. 91:328–332. 1996.
26	Lapidus A, Bernell O, Hellers G and Lofberg R: Clinical course of colorectal Crohn's disease: a 35-year follow-up study of 507 patients. Gastroenterology. 114:1151–1160. 1998.
27	Schwartz DA, Pemberton JH and Sandborn WJ: Diagnosis and treatment of perianal fistulas in Crohn disease. Ann Intern Med. 135:906–918. 2001. View Article : Google Scholar : PubMed/NCBI
28	Wolf J: Ciprofloxacin may be useful in Crohn's disease. Gastroenterology. 98:(abstract). A2121990.
29	Uza N, Nakase H, Ueno S, et al: The effect of medical treatment on patients with fistulizing Crohn's disease: a retrospective study. Intern Med. 47:193–199. 2008. View Article : Google Scholar
30	Turunen U, Farkkila M, Valtonen V, et al: Longterm outcome of ciprofloxacin treatment in severe perianal or fistulous Crohn's disease. Gastroenterology. 104:(abstract). A7931993.