Long-term treatment of ulcerative colitis with ciprofloxacin: A prospective, double-blind, placebo-controlled study

Turunen, Ulla; Färkkilä, Martti; Hakala, Kristo; Seppälä, K; Sivonen, Aulikki; Ögren, Magnus; Vuoristo, Matti; Valtonen, Ville; Miettinen, Tatu A.

doi:10.1016/s0016-5085(98)70076-9

Cited by 217 publications

(98 citation statements)

References 24 publications

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“…Decreasing the concentration of luminal bacteria, especially of anaerobic bacteria, can be beneficial in both clinical and experimental enterocolitis [13, 14, 15, 16]. Supporting this view, it has been demonstrated that human ileocolitis responds to several antibiotics including metronidazole and ciprofloxacin which is selectively active against anaerobic bacteria [17, 18, 19]. …”

Section: Introductionmentioning

confidence: 99%

Inhibition of Intestinal Bacterial Translocation with Rifaximin Modulates Lamina propria Monocytic Cells Reactivity and Protects against Inflammation in a Rodent Model of Colitis

et al. 2002

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Background: A modification of the intestinal flora and an increased bacterial translocation is a common finding in patients with inflammatory bowel disease as well as in animal model of colitis. Rifaximin, a non-absorbable derivative of rifamycin, is an effective antibiotic that acts by inhibiting bacterial ribonucleic acid synthesis. Aims: In the present study, we investigated the effect of the administration of rifaximin (10, 30 and 50 mg/kg/day) or prednisolone (10 mg/kg/day) in 2,4,6-trinitrobenzene sulfonic acid (TNBS)-induced colitis in mice. Methods: Colitis was induced in mice by intrarectal administration of TNBS (1.5 mg/mouse in 50% ethanol) and disease severity assessed clinically and by histologic scoring of colon damage, determination of interleukin (IL)-2, IL-12, interferon (IFN)-γ and tumor necrosis factor (TNF)-α (protein and mRNA and myeloperoxidase (MPO) activity in the colon. Cytokines production by the lamina propria mononuclear cells (LPMC) and luminal bacteria were also measured. Results: Rifaximin administration (30 or 50 mg/kg/day) increased survival rates of colitic mice and reduced colitis severity as demonstrated by improvement of wasting syndrome, histologic scores, decrease in colon IL-2, IL-12, IFN-γ and TNF-α (protein and mRNA) levels, and diminished colon MPO activity. Rifaximin administration caused a significant reduction of colon bacterial translocation towards mesenteric lymph nodes. LPMC obtained from rifaximin-treated mice released significantly lower amount of IFN-γ in response to ex vivo stimulation with agonistic anti-CD3 and anti-CD28 antibodies. Rifaximin (50 mg/kg/day) significantly accelerates recovery in mice with established colitis. Conclusions: Luminal bacterial microflora plays a role in the pathogenesis of TNBS-induced colitis in mice. Rifaximin administration reduces the development of colitis and accelerates healing of established disease by preventing bacterial translocation.

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Section: Introductionmentioning

confidence: 99%

Inhibition of Intestinal Bacterial Translocation with Rifaximin Modulates Lamina propria Monocytic Cells Reactivity and Protects against Inflammation in a Rodent Model of Colitis

et al. 2002

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“…In various trials, there are examples of successfully using single antibiotics in refractory UC [5,6]. Recently, a triple-antibiotic regime has been shown in an open-label, multicenter study to be effective in steroid-free remission of moderate-to-severe UC [7].…”

Section: Case Reportmentioning

confidence: 99%

Successful management of refractory ulcerative colitis with orally administered serum-derived bovine immunoglobulin therapy

2015

Clin Case Rep Rev

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This case describes a female patient with a long history of pan-colitis (>10 years) with a recent flare of disease precipitated by a Clostridium difficile infection (CDI) after experiencing septic arthritis. The CDI was successfully treated with vancomycin confirmed by a negative PCR test. The patient then experienced a flare of ulcerative colitis (UC) with 7-8 watery, bloody stools per day with cramping. Initial treatment with 30 mg oral prednisone daily and rectal mesalamine, 1 g QHS, at bedtime resulted in no change in condition. Increased oral steroid (40 mg q.d.) caused an increase of watery, bloody stools to 10-15 per day. The patient was advised to include oral serum-derived bovine immunoglobulin/protein isolate (SBI), a prescription medical food, in combination with oral steroids. Over two months, this combination effectively resolved gastrointestinal symptoms and a repeat flexible sigmoidoscopy demonstrated mucosal healing (from Mayo UC score grade 2 to grade 0). The steroid dose was tapered from 40 mg to 5 mg in combination with SBI and the patient continues to be maintained on both therapeutics for a year. We discuss the unique complications of managing this particular patient, her refusal of anti-TNF therapies and why SBI was a therapeutic option in this case.

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“…Both ciprofloxacin, tobramycin and metronidazole have been studied, despite a clear trend toward improvement, showed no superiority in terms of the induction or maintenance of remission in UC [38]. Although in some studies there was a clinical/endoscopic response about 80%, sustained remission was not obtained, and recurrence was similar to placebo [39].…”

Section: Antibioticsmentioning

confidence: 99%

Ulcerative Proctitis

Caselli¹,

Pinedo²

2011

Ulcerative Colitis - Epidemiology, Pathogenesis and Complications

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Long-term treatment of ulcerative colitis with ciprofloxacin: A prospective, double-blind, placebo-controlled study

Cited by 217 publications

References 24 publications

Inhibition of Intestinal Bacterial Translocation with Rifaximin Modulates Lamina propria Monocytic Cells Reactivity and Protects against Inflammation in a Rodent Model of Colitis

Inhibition of Intestinal Bacterial Translocation with Rifaximin Modulates Lamina propria Monocytic Cells Reactivity and Protects against Inflammation in a Rodent Model of Colitis

Successful management of refractory ulcerative colitis with orally administered serum-derived bovine immunoglobulin therapy

Ulcerative Proctitis

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