PMID- 26541937
OWN - NLM
STAT- MEDLINE
DCOM- 20160706
LR  - 20181202
IS  - 1365-2036 (Electronic)
IS  - 0269-2813 (Print)
IS  - 0269-2813 (Linking)
VI  - 43
IP  - 1
DP  - 2016 Jan
TI  - Adjuvant use of antibiotics with corticosteroids in inflammatory bowel disease 
      exacerbations requiring hospitalisation: a retrospective cohort study and 
      meta-analysis.
PG  - 52-60
LID - 10.1111/apt.13454 [doi]
AB  - BACKGROUND: Patients hospitalised with an exacerbation of inflammatory bowel 
      disease (IBD) often receive antibiotics in addition to intravenous steroids. 
      However, their efficacy in this setting is unclear. AIM: To ascertain if the 
      addition of antibiotics to intravenous steroids modifies short and long-term 
      clinical outcomes. METHODS: Our study included IBD patients hospitalised between 
      2009 and 2014 who received intravenous (IV) steroids with or without adjuvant 
      antibiotics. Outcomes of interest included length of stay (LOS), need for medical 
      and surgical rescue therapy during the hospitalisation, and at 90 and 365 days. A 
      meta-analysis of previously published randomised trials was additionally 
      performed. RESULTS: A total of 354 patients were included [145 ulcerative colitis 
      (UC); 209 Crohn's disease (CD)]. In CD, combination of IV steroids and 
      antibiotics did not change need for in-hospital medical rescue therapy, surgery 
      or hospitalisations at 1 year but was associated with greater LOS (6.1 vs. 4.6 
      days, P = 0.02). In UC, patients receiving antibiotics were less likely to 
      require in-hospital medical rescue therapy [odds ratio (OR): 0.42, 95% confidence 
      interval (CI): 0.19-0.93] but experienced no statistically significant 
      differences in LOS, in-hospital surgery, re-hospitalisations or surgery by 1 
      year. A meta-analysis of three relevant randomised trials demonstrated no 
      difference in clinical improvement with antibiotics over placebo (OR: 1.08, 95% 
      CI: 0.50-2.32). CONCLUSIONS: The addition of antibiotics to intravenous steroids 
      for treatment of IBD exacerbations was associated with a reduced need for 
      in-hospital medical rescue therapy in ulcerative colitis without significant 
      long-term benefit, and did not affect short- or long-term outcomes in Crohn's 
      disease.
CI  - (c) 2015 John Wiley & Sons Ltd.
FAU - Gupta, V
AU  - Gupta V
AD  - Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
FAU - Rodrigues, R
AU  - Rodrigues R
AD  - North Shore Community Health Center, Salem, MA, USA.
FAU - Nguyen, D
AU  - Nguyen D
AD  - Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Sauk, J
AU  - Sauk J
AD  - Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Khalili, H
AU  - Khalili H
AD  - Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Yajnik, V
AU  - Yajnik V
AD  - Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
FAU - Ananthakrishnan, A N
AU  - Ananthakrishnan AN
AD  - Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
AD  - Division of Gastroenterology, Massachusetts General Hospital, Boston, MA, USA.
AD  - Harvard Medical School, Boston, MA, USA.
LA  - eng
GR  - K23 DK097142/DK/NIDDK NIH HHS/United States
GR  - K23 DK099681/DK/NIDDK NIH HHS/United States
GR  - P30 DK043351/DK/NIDDK NIH HHS/United States
PT  - Journal Article
PT  - Observational Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
DEP - 20151105
PL  - England
TA  - Aliment Pharmacol Ther
JT  - Alimentary pharmacology & therapeutics
JID - 8707234
RN  - 0 (Adrenal Cortex Hormones)
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Adrenal Cortex Hormones/administration & dosage/*therapeutic use
MH  - Adult
MH  - Anti-Bacterial Agents/administration & dosage/*therapeutic use
MH  - Cohort Studies
MH  - Colitis, Ulcerative/*drug therapy
MH  - Crohn Disease/*drug therapy
MH  - Drug Therapy, Combination
MH  - Female
MH  - Hospitalization/statistics & numerical data
MH  - Humans
MH  - Male
MH  - Meta-Analysis as Topic
MH  - Randomized Controlled Trials as Topic
MH  - Retrospective Studies
PMC - PMC4673010
MID - NIHMS731140
COIS- Disclosures [Table: see text]
EDAT- 2015/11/07 06:00
MHDA- 2016/07/07 06:00
PMCR- 2017/01/01
CRDT- 2015/11/07 06:00
PHST- 2015/08/03 00:00 [received]
PHST- 2015/09/25 00:00 [revised]
PHST- 2015/10/07 00:00 [revised]
PHST- 2015/10/12 00:00 [accepted]
PHST- 2015/11/07 06:00 [entrez]
PHST- 2015/11/07 06:00 [pubmed]
PHST- 2016/07/07 06:00 [medline]
PHST- 2017/01/01 00:00 [pmc-release]
AID - 10.1111/apt.13454 [doi]
PST - ppublish
SO  - Aliment Pharmacol Ther. 2016 Jan;43(1):52-60. doi: 10.1111/apt.13454. Epub 2015 
      Nov 5.