Several therapies that modulate gut microbiota, such as antibiotics and probiotics, have been assessed in IBD1-3:
Antibiotics may reduce certain symptoms of IBD by decreasing overall bacterial burden; however, their role in clinical practice remains limited.2 Antibiotic monotherapy has provided some benefit in managing complications of Crohn’s colitis, such as abscesses and fistulae, and may prevent post-resection recurrence. The use of certain antibiotics in combination may also improve outcomes; however, use is limited due to the risk of resistance development. Currently, no benefits have been found with antibiotic use in ulcerative colitis.2,10
Probiotics have been used in an attempt to create a healthy balance in the global composition of gut microbiota. While certain probiotics have shown benefits in managing ulcerative colitis, this approach has demonstrated limited efficacy in Crohn’s disease.1,2
Research is focusing on the benefits of experimental therapies, such as fecal microbiota transplantation, in IBD. Most microbiome-based therapies require further investigation before they can be used in routine clinical practice. Such modalities will likely require a personalized approach to determine which patients may benefit.1,2
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