Document Detail


Two-year-outcomes analysis of Crohn's disease treated with rifabutin and macrolide antibiotics.
MedLine Citation:
PMID:  9096189     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
G P Gui; P R Thomas; M L Tizard; J Lake; J D Sanderson; J Hermon-Taylor
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Journal of antimicrobial chemotherapy     Volume:  39     ISSN:  0305-7453     ISO Abbreviation:  J. Antimicrob. Chemother.     Publication Date:  1997 Mar 
Date Detail:
Created Date:  1997-08-07     Completed Date:  1997-08-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7513617     Medline TA:  J Antimicrob Chemother     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  393-400     Citation Subset:  IM    
Affiliation:
University Department of Surgery, St George's Hospital Medical School, London, UK.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anti-Bacterial Agents / therapeutic use*
Blood Sedimentation
C-Reactive Protein / analysis
Clarithromycin / therapeutic use
Crohn Disease / blood,  drug therapy*
Female
Follow-Up Studies
Humans
Male
Middle Aged
Outcome Assessment (Health Care)*
Proportional Hazards Models
Remission Induction
Rifabutin / therapeutic use*
Serum Albumin / analysis
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Serum Albumin; 72559-06-9/Rifabutin; 81103-11-9/Clarithromycin; 9007-41-4/C-Reactive Protein

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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