Effect of antibiotic therapy in patients with ulcerative colitis: a meta-analysis of randomized controlled trials

Abstract

Background

Gut microbiota may play a role in the pathogenesis of ulcerative colitis (UC). Antibiotic therapy for patients with UC has shown conflicting results.

Objectives

To evaluate the effect of antibiotic therapy in treating UC.

Methods

PubMed, EMBASE, Cochrane Library, Wanfang Data, and China National Knowledge Infrastructure (CNKI) databases were searched to identify randomized controlled trials (RCTs) that evaluated antibiotics compared with placebo or no antibiotics in patients with UC. We extracted and pooled the risk ratio (RR).

Results

Twelve RCTs were included in this systematic review and meta-analysis, which included 739 patients with active UC. Antibiotic therapy had statistically significant efficacy in inducing remission rate in patients with UC, observed at the end of trials (random-effect RR = 0.77; 95% confidence interval [CI] 0.60 to 0.98, p = .03) or at 12 months after trials (fixed-effect RR = 0.83; 95% CI 0.73 to 0.94, p = .003).

Conclusions

Antibiotic therapy appeared to induce remission more effectively than a placebo or no antibiotic intervention not only in the short-term but also in the long-term for patients with UC. More high-quality clinical trials are needed before clinical recommendations for antibiotic therapy in UC management are made.

Keywords:

• Ulcerative colitis
• inflammatory bowel disease antibiotics
• randomized controlled trials
• meta-analysis

Author contributions

Yunsheng Yang was responsible for the idea and prepared the manuscript. Wenjie Xi contributed the literature search, data acquisition, data analysis and manuscript preparation. Zongwei Li participated in the literature search and data acquisition. Rongrong Ren participated in the literature search and data analysis. Xiaoyong Sai participated in the methodology and data analysis. Lihua Peng was responsible for reviewing outcome measurement criteria. All authors were involved in critically revising the manuscript. All authors approved the final manuscript for submission.

Disclosure statement

The authors declare no conflict of interest related to this study.