Abstract：
There is abundant literature reporting about the use of antibiotics in inflammatory bowel disease (IBD), but their role in the management of IBD is not entirely clear. Diverse infectious organisms have been implicated in the pathogenesis of Crohn\'s disease. Also, infections are believed to be a trigger for flares of ulcerative colitis. The benefit of the routine use of antibiotics in IBD is equivocal. However, there are certain situations, where antibiotics have a clear role and evidence of benefit: perianal fistula, intra-abdominal abscesses in Crohn\'s disease, acute pouchitis and infection-related flares. However, there is a lack of supportive evidence for the routine use of antibiotics in all disease-related flares. Evidence indicates a lack of benefit of intravenous antibiotics in acute severe ulcerative colitis and only limited benefit in active ulcerative colitis. Limited evidence suggests the role of a combination of oral antibiotics in pediatric ulcerative colitis. Certain targeted antibiotic regimens have been used in IBD. In ulcerative colitis, limited evidence suggests the benefit of the use of an antibiotic cocktail directed against Fusobacterium varium. Therapy directed against Escherichia coli does not seem to have a benefit in inflammatory Crohn\'s disease. In Crohn\'s disease, antimycobacterial therapy may result in symptomatic improvement but no durable benefit. Antitubercular therapy (ATT), on the contrary, may result in fibrotic transformation, suggesting a need to avoid misdiagnosis and limit the duration of ATT in Crohn\'s disease. This review assesses the published literature with respect to antibiotic use and provides guidance to clinicians in appropriate antibiotic use in various situations in the setting of IBD.
摘要：
有大量文献报道抗生素在炎症性肠病（IBD）中的使用，但它们在IBD管理中的作用尚不完全清楚。克罗恩病的发病机制涉及多种感染性生物。此外，感染被认为是溃疡性结肠炎耀斑的触发因素.在IBD中常规使用抗生素的益处是模棱两可的。然而,有些情况,抗生素有明确的作用和益处的证据：肛周瘘，克罗恩病的腹内脓肿，急性囊炎和感染相关的耀斑。然而,在所有疾病相关的耀斑中,缺乏常规使用抗生素的支持性证据.有证据表明静脉注射抗生素在急性重度溃疡性结肠炎中缺乏益处，而在活动性溃疡性结肠炎中仅有有限的益处。有限的证据表明口服抗生素组合在小儿溃疡性结肠炎中的作用。某些靶向抗生素方案已用于IBD。在溃疡性结肠炎中，有限的证据表明,使用针对一株梭菌的抗生素混合物具有益处.针对大肠杆菌的治疗似乎对炎症性克罗恩病没有益处。在克罗恩病，抗分枝杆菌治疗可能会改善症状，但没有持久的益处。抗结核治疗(ATT),相反,可能导致纤维化转化，提示需要避免误诊并限制克罗恩病中ATT的持续时间。这篇综述评估了有关抗生素使用的已发表文献，并为临床医生在IBD的各种情况下适当使用抗生素提供了指导。
