Effectiveness of adjunctive use of antibiotics in acute severe ulcerative colitis: a propensity score matching analysis.

IF 4.7 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2026-07-01 DOI:10.5217/ir.2025.00341

Hye Kyung Hyun, Jihye Park, Soo Jung Park, Jae Jun Park, Tae Il Kim, Nak-Hoon Son, Jae Hee Cheon

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引用次数: 0

Abstract

Background/aims: The exact cause of ulcerative colitis (UC) remains unclear but likely involves an immune response to an unidentified component of gut microbiota. The use of antibiotics in treating acute severe UC (ASUC) remains controversial. This study aimed to assess the benefits of adding antibiotics to corticosteroids for managing ASUC.

Methods: This retrospective study included patients with ASUC who met the Truelove and Witts diagnostic criteria at admission and received intravenous (IV) corticosteroids, with or without adjunctive antibiotics. Key outcomes included the need for medical and surgical rescue therapy during hospitalization and UC-related re-hospitalization rates at 1 week, 3 months, and 1 year. Propensity score matching (PSM) was employed to minimize selection bias in evaluating the impact of adjunctive antibiotics on clinical outcomes.

Results: Of the 386 screened patients, 222 met the inclusion criteria: 75 (33.8%) received IV corticosteroids alone, while 147 (66.2%) received IV corticosteroids combined with antibiotics. After PSM (60 patients per group), the addition of antibiotics showed no significant effect on the need for medical rescue therapy during hospitalization, re-hospitalization, or clinical response based on the partial Mayo score after 1 week of hospitalization (68.3% vs. 60.0%; P= 0.341). Similarly, no significant differences were observed in the need for medical rescue therapy, re-hospitalization, or UC-related surgery rates at 3 months or 1 year (P> 0.05).

Conclusions: In patients with ASUC, treatment outcomes did not significantly differ between those receiving IV corticosteroids alone and those receiving a combination of IV corticosteroids and antibiotics, suggesting that adjunctive antibiotic use may offer no added clinical benefits.

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急性严重溃疡性结肠炎辅助使用抗生素的有效性：倾向评分匹配分析。

背景/目的：溃疡性结肠炎（UC）的确切病因尚不清楚，但可能涉及对肠道微生物群中未知成分的免疫反应。使用抗生素治疗急性重症UC （ASUC）仍然存在争议。本研究旨在评估在皮质类固醇中添加抗生素治疗ASUC的益处。方法：本回顾性研究纳入了入院时符合Truelove和Witts诊断标准并接受静脉注射（IV）皮质激素治疗的ASUC患者，伴或不伴辅助抗生素。主要结局包括住院期间是否需要内科和外科抢救治疗，以及1周、3个月和1年的uc相关再住院率。在评估辅助抗生素对临床结果的影响时，采用倾向评分匹配（PSM）来最小化选择偏差。结果：在386例筛查患者中，222例符合纳入标准：单独静脉注射糖皮质激素75例（33.8%），静脉注射糖皮质激素联合抗生素147例（66.2%）。经PSM（每组60例）治疗后，抗生素的添加对住院期间、再次住院、住院1周后部分Mayo评分临床反应的医学抢救治疗需求无显著影响（68.3% vs. 60.0%； P= 0.341）。同样，在3个月或1年的医疗抢救治疗需求、再次住院或uc相关手术率方面，也没有观察到显著差异（P < 0.05）。结论：在ASUC患者中，单独使用糖皮质激素和联合使用糖皮质激素和抗生素的治疗结果没有显著差异，这表明使用辅助抗生素可能不会带来额外的临床益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.