Journal of Antimicrobial Chemotherapy, Vol 39, 393-400, Copyright © 1997 by The British Society for Antimicrobial Chemotherapy
GP Gui, PR Thomas, ML Tizard, J Lake, JD Sanderson and J Hermon-Taylor
Fifty-two patients with severe Crohn's disease were enrolled in this study.
Six (11.5%) were intolerant of the medication and had to be excluded. The
remaining 46 patients were treated with rifabutin in combination with a
macrolide antibiotic (clarithromycin or azithromycin). Patients were
treated for a mean of 18.7 (range 6-35) months and followed up for 25.1
(range 7-41) months. Of the 19 patients who were steroid dependent at the
start of this study, only two continued to require steroids when treatment
was established. A reduction in the Harvey-Bradshaw Crohn's disease
activity index occurred after 6 months' treatment (P = 0.004, paired
Wilcoxon test) and was maintained at 24 months (P < 0.001). An
improvement in inflammatory parameters was observed as measured by a
reduction in erythrocyte sedimentation rate (P = 0.009) and C-reactive
protein (P = 0.03) at 18 months compared with pretreatment levels, and an
increase in serum albumin at 12 months (P = 0.04). When subsets of the
study population were analysed, patients with pan-intestinal disease
achieved better remission at 2 years than did those with less extensive
involvement (P = 0.04, Mann-Whitney U-test). No difference in treatment
response by age, disease duration, the presence of granulomas on histology,
or the occurrence of drug-induced side-effects, was observed. These data
suggest that treatment with rifabutin and clarithromycin or azithromycin
may result in a substantial clinical improvement in Crohn's disease and
justify the conduct of a randomized controlled trial.
JOURNAL ARTICLE
Two-year-outcomes analysis of Crohn's disease treated with rifabutin and macrolide antibiotics
University Department of Surgery, St George's Hospital Medical School, London, UK.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Y. Krishnan, E. J. B. Manning, and M. T. Collins Effects of interactions of antibacterial drugs with each other and with 6-mercaptopurine on in vitro growth of Mycobacterium avium subspecies paratuberculosis J. Antimicrob. Chemother., November 1, 2009; 64(5): 1018 - 1023. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Shin and M. T. Collins Thiopurine Drugs Azathioprine and 6-Mercaptopurine Inhibit Mycobacterium paratuberculosis Growth In Vitro Antimicrob. Agents Chemother., February 1, 2008; 52(2): 418 - 426. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R B. Sartor Does Mycobacterium avium subspecies paratuberculosis cause Crohn's disease? Gut, July 1, 2005; 54(7): 896 - 898. [Full Text] [PDF]
|
|
|
|
|
|
F Autschbach, S Eisold, U Hinz, S Zinser, M Linnebacher, T Giese, T Loffler, M W Buchler, and J Schmidt High prevalence of Mycobacterium avium subspecies paratuberculosis IS900 DNA in gut tissues from individuals with Crohn's disease Gut, July 1, 2005; 54(7): 944 - 949. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. A. Vallance, M. I. Gunawan, B. Hewlett, P. Bercik, C. Van Kampen, F. Galeazzi, P. J. Sime, J. Gauldie, and S. M. Collins TGF-{beta}1 gene transfer to the mouse colon leads to intestinal fibrosis Am J Physiol Gastrointest Liver Physiol, July 1, 2005; 289(1): G116 - G128. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 O Awotesu, T Missotten, M C Pitcher, W A Lynn, and S Lightman Uveitis in a patient receiving rifabutin for Crohn's disease J R Soc Med, September 1, 2004; 97(9): 440 - 441. [Full Text] [PDF]
|
|
|
|
 |
|
 T. J. Bull, E. J. McMinn, K. Sidi-Boumedine, A. Skull, D. Durkin, P. Neild, G. Rhodes, R. Pickup, and J. Hermon-Taylor Detection and Verification of Mycobacterium avium subsp. paratuberculosis in Fresh Ileocolonic Mucosal Biopsy Specimens from Individuals with and without Crohn's Disease J. Clin. Microbiol., July 1, 2003; 41(7): 2915 - 2923. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. Wei, T. Huang, H. Dalwadi, C. L. Sutton, D. Bruckner, and J. Braun Pseudomonas fluorescens Encodes the Crohn's Disease-Associated I2 Sequence and T-Cell Superantigen Infect. Immun., December 1, 2002; 70(12): 6567 - 6575. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Bamias, M. Marini, C. A. Moskaluk, M. Odashima, W. G. Ross, J. Rivera-Nieves, and F. Cominelli Down-Regulation of Intestinal Lymphocyte Activation and Th1 Cytokine Production by Antibiotic Therapy in a Murine Model of Crohn's Disease J. Immunol., November 1, 2002; 169(9): 5308 - 5314. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J Hermon-Taylor PROTAGONIST: Mycobacterium avium subspecies paratuberculosis is a cause of Crohn's disease Gut, December 1, 2001; 49(6): 755 - 757. [Full Text] [PDF]
|
|
|
|
|
|
C L Sutton, H Yang, Z Li, J I Rotter, S R Targan, and J Braun Familial expression of anti-Saccharomyces cerevisiae mannan antibodies in affected and unaffected relatives of patients with Crohn's disease Gut, January 1, 2000; 46(1): 58 - 63. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O. Cohavy, G. Harth, M. Horwitz, M. Eggena, C. Landers, C. Sutton, S. R. Targan, and J. Braun Identification of a Novel Mycobacterial Histone H1 Homologue (HupB) as an Antigenic Target of pANCA Monoclonal Antibody and Serum Immunoglobulin A from Patients with Crohn's Disease Infect. Immun., December 1, 1999; 67(12): 6510 - 6517. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Hermon-Taylor, N. Barnes, C. Clarke, and C. Finlayson Grand Round: Mycobacterium paratuberculosis cervical lymphadenitis, followed five years later by terminal ileitis similar to Crohn's disease BMJ, February 7, 1998; 316(7129): 449 - 453. [Full Text]
|
|