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Ciprofloxacin for the Prevention of Postoperative Recurrence in Patients with Crohnʼs Disease
| Content Provider | Scilit |
|---|---|
| Author | Herfarth, Hans H. Katz, Jeffry A. Hanauer, Stephen B. Sandborn, William J. Loftus, Edward V. Sands, Bruce E. Galanko, Joseph A. Walkup, Dolly Isaacs, Kim L. Martin, Christopher F. Sandler, Robert S. Sartor, Ryan B. |
| Copyright Year | 2013 |
| Description | Journal: Inflammatory Bowel Diseases The commensal bacterial flora plays a critical role in the postoperative recurrence of Crohn's disease (CD). We conducted a randomized, double-blind, placebo-controlled 6-month pilot trial of ciprofloxacin for the prevention of endoscopic recurrence in patients with CD who underwent surgery. Thirty-three patients with CD, who had undergone surgery with ileocolonic anastomosis within the previous 2 weeks, were randomized to treatment with ciprofloxacin (500 mg twice daily) or placebo tablets for 6 months. Endpoints were endoscopic recurrence at 6 months and safety and tolerability of long-term ciprofloxacin therapy. Thirty-three patients were randomized; 14 patients discontinued the study early. Significant endoscopic recurrence was observed in 3 of 9 patients (33%) in the ciprofloxacin group and 5 of 10 patients (50%) in the placebo group at 6 months after surgery (P < 0.578). The intention-to-treat analysis demonstrated endoscopic recurrence in 11 of 17 patients (65%) in the ciprofloxacin group and 11 of 16 patients (69%) in the placebo group at month 6 (P < 0.805). Thirty-six adverse events occurred in 19 of 33 patients (58%). Possible drug-associated adverse events occurred significantly more often in the ciprofloxacin group (P < 0.043), leading to study drug discontinuation in 24% (4 of 17) and 6% of patients (1 of 16) in the ciprofloxacin and placebo groups, respectively (P < 0.166). In this pilot study, ciprofloxacin was not more effective than placebo for the prevention of postoperative recurrence in patients with CD. Long-term ciprofloxacin therapy is limited by drug-associated side effects. Future studies in postoperative prevention of CD should evaluate antibiotic approaches with a more favorable safety profile. |
| Related Links | http://pdfs.journals.lww.com/ibdjournal/2013/05000/Ciprofloxacin_for_the_Prevention_of_Postoperative.23.pdf?token=method|ExpireAbsolute;source|Journals;ttl|1506836653292;payload|mY8D3u1TCCsNvP5E421JYK6N6XICDamxByyYpaNzk7FKjTaa1Yz22MivkHZqjGP4kdS2v0J76WGAnHACH69s21Csk0OpQi3YbjEMdSoz2UhVybFqQxA7lKwSUlA502zQZr96TQRwhVlocEp/sJ586aVbcBFlltKNKo+tbuMfL73hiPqJliudqs17cHeLcLbV/CqjlP3IO0jGHlHQtJWcICDdAyGJMnpi6RlbEJaRheGeh5z5uvqz3FLHgPKVXJzdFjgCJ8jBy+xQ4EOiUPiPq6aIln9XsyaPxpEHb1lJt0s=;hash|fwyxYyAkYMadKnOxAV9o+A== https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4596532/pdf https://academic.oup.com/ibdjournal/article-pdf/19/5/1073/23424780/ibd1073.pdf |
| Ending Page | 1079 |
| Page Count | 7 |
| Starting Page | 1073 |
| ISSN | 10780998 |
| e-ISSN | 15364844 |
| DOI | 10.1097/01.MIB.0000428910.36091.10 |
| Journal | Inflammatory Bowel Diseases |
| Issue Number | 5 |
| Volume Number | 19 |
| Language | English |
| Publisher | Ovid Technologies (Wolters Kluwer Health) |
| Publisher Date | 2013-04-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Inflammatory Bowel Diseases Gastroenterology and Hepatology Crohn's Disease/surgery Anti-infective Agents/adverse Effects Inflammatory Bowel Diseases |
| Content Type | Text |
| Resource Type | Article |
| Subject | Immunology and Allergy Gastroenterology |
