{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T12:31:42Z","timestamp":1789475502030,"version":"build-2803163510"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":7,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["JGH Open"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Mycobacterium avium<\/jats:italic>\n                    <\/jats:styled-content>\n                    subspecies\n                    <jats:italic>paratuberculosis<\/jats:italic>\n                    (MAP) as the infectious cause of Crohn's disease and the use of antimycobacterial (anti\u2010MAP) therapies in its treatment remain topics of controversy. A major limitation accepting this view is that irrefutable evidence that MAP causes Crohn's disease\u2014the demonstration that long\u2010term remission follows clearance of the infection with antibiotics\u2014has been lacking. While several centers continue to advocate their use, most authoritative guidelines do not recommend anti\u2010MAP regimens. This viewpoint aims to evaluate current data, in particular, the results of randomized controlled trials (RCTs) of anti\u2010MAP therapy published in 2007 and in 2024. We conclude that, similar to several other antibiotic regimens, the benefit of anti\u2010MAP therapy in active Crohn's Disease (CD) is likely to be modest. Continuing treatment is unlikely to be of benefit if there is no significant objective improvement in disease activity by 16\u2009weeks. Any beneficial effect of anti\u2010MAP therapy is not maintained after its discontinuation. There is still no convincing evidence that the causative microorganism of Crohn's disease is\n                    <jats:styled-content style=\"fixed-case\">\n                      <jats:italic>Mycobacterium avium<\/jats:italic>\n                    <\/jats:styled-content>\n                    ssp.\n                    <jats:italic>paratuberculosis<\/jats:italic>\n                    in significant numbers of patients.\n                  <\/jats:p>","DOI":"10.1002\/jgh3.70293","type":"journal-article","created":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T05:04:02Z","timestamp":1759986242000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Viewpoint: The Use of Antimycobacterial (Anti\u2010\n                    <scp>MAP<\/scp>\n                    ) Therapies in the Treatment of Active Luminal Crohn's Disease"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1891-8410","authenticated-orcid":false,"given":"Paul","family":"Pavli","sequence":"first","affiliation":[{"name":"School of Medicine and Psychology, College of Science and Medicine Australian National University  Canberra Australia"},{"name":"Gastroenterology and Hepatology Unit Canberra Hospital  Woden ACT Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9108-1712","authenticated-orcid":false,"given":"Peter R.","family":"Gibson","sequence":"additional","affiliation":[{"name":"School of Translational Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,8]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2007.04.027"},{"key":"e_1_2_14_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198601163140314"},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(87)91276-1"},{"key":"e_1_2_14_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)91334-7"},{"key":"e_1_2_14_6_1","first-page":"A458","article-title":"Use of Rifabutin and Streptomycin in the Therapy of Crohn's Disease","volume":"94","author":"Thayer W. 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