ArticleInflammatory bowel diseases2019
Efficacy of Combination Antibiotic Therapy for Refractory Pediatric Inflammatory Bowel Disease.
Article in Inflammatory bowel diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 43 citations in OpenAlex.
- Management of paediatric ulcerative colitis, part 1: Ambulatory care-An updated evidence-based consensus guideline from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition and the European Crohn's and Colitis Organisation.Journal of pediatric gastroenterology and nutrition · 2025Guideline
- Antibiotics for the induction and maintenance of remission in ulcerative colitis.The Cochrane database of systematic reviews · 2022Pooled it
- Platelet perturbation to ciprofloxacin exacerbates IBD through regulation of HLA DR on CD14⁻CD16⁺ monocytes.Internal and emergency medicine · 2026Article
- Antibiotic Effect on Clinical Response and Remission in Pediatric Inflammatory Bowel Disease.Pediatric reports · 2025Article
- Gut Feelings: How Microbes, Diet, and Host Immunity Shape Disease.Biomedicines · 2025Review
- Long-term outcome of pediatric acute severe colitis: A prospective 5-year follow-up of the PRASCO trial.Journal of pediatric gastroenterology and nutrition · 2025Article
- Review
- Article
- Antibiotic combination therapy for the induction and maintenance of remission in patients with ulcerative colitis.Bioscience of microbiota, food and health · 2025Article
- Prevalence of Plasmid-Mediated Quinolone Resistance Genes inHealth science reports · 2024Article
- Article
- Fetal and Early-Life Antibiotics and Risk of Pediatric Inflammatory Bowel Disease: A Population-Based Nationwide Register Study.Journal of pediatrics. Clinical practice · 2024Article
- A Single-Center Study of Long-Term Effectiveness of Vedolizumab in Anti-TNF Refractory Pediatric Inflammatory Bowel Disease.JPGN reports · 2023Article
- Patient-Reported Outcomes Correlate With Microbial Community Composition Independent of Mucosal Inflammation in Pediatric Inflammatory Bowel Disease.Inflammatory bowel diseases · 2023Article
- The role of complex interactions between the intestinal flora and host in regulating intestinal homeostasis and inflammatory bowel disease.Frontiers in microbiology · 2023Review
- The epidemiology of inflammatory bowel disease: Clues to pathogenesis?Frontiers in pediatrics · 2022Review
- The Potential Immunomodulatory Properties of Levornidazole Contribute to Improvement in Experimental Ulcerative Colitis.Current medical science · 2021Article
- Colitis susceptibility in mice with reactive oxygen species deficiency is mediated by mucus barrier and immune defense defects.Mucosal immunology · 2019Article
- Clinical characteristics of colitis induced by taxane-based chemotherapy.Annals of gastroenterologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 1 institution in 1 country.
Funding
Abstract
backgroundRecent studies have shown that oral combination antibiotics may improve disease course in refractory inflammatory bowel disease (IBD). Here, we describe the use of combination oral antibiotics as salvage therapy in refractory ulcerative colitis (UC), Crohn's colitis, and IBD-unclassified (IBD-U) at a large pediatric IBD center.
methodsClinical response, disease activity indices, adverse events, and clinical outcomes were measured up to 1 year after antibiotic treatment in this retrospective cohort study of children with medically refractory IBD colitis.
resultsSixty-three patients with refractory UC, Crohn's colitis, and IBD-U (median age [interquartile range {IQR}], 15.3 [11.2-16.5] years; median disease duration [IQR], 1.2 [0.41-4.6] years) received a combination of 3 or 4 oral antibiotics (most commonly amoxicillin, metronidazole, and either doxycycline or ciprofloxacin) for a median (IQR) of 29 (21-58) days. Thirty-four patients (54%) were deemed corticosteroid-refractory or -dependent, with the majority (62/63) having a previous or present loss of response or primary nonresponse to anti-tumor necrosis factor alpha (anti-TNFα) therapy. Use of combination antibiotics led to a significant decrease in median Pediatric Ulcerative Colitis Activity Index (PUCAI) score (IQR) from 55 (40-65) to 10 (0-40; P < 0.0001) over 3 ± 1 weeks, with 25/63 (39.7%) patients achieving clinical remission (PUCAI <10 points). The clinical benefits of oral antibiotics were independent of anti-TNFα therapy optimization. Among children entering clinical remission (n = 25), only 1 patient required surgery at 1-year follow-up, vs 10 patients in the nonresponder group. Negative predictors of response to combination antibiotics were exposure to doxycycline (odds ratio [OR], 0.25; 95% CI, 0.08-0.76) and PUCAI ≥65 at baseline (OR, 0.2; 95% CI, 0.05-0.74).
conclusionsOral combination antibiotics appears to be an effective rescue and steroid-sparing therapy to induce remission in the short term in patients failing a biologic.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.