{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T03:51:55Z","timestamp":1780890715565,"version":"3.54.1"},"reference-count":75,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,2,3]],"date-time":"2024-02-03T00:00:00Z","timestamp":1706918400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Antibiotics"],"abstract":"<jats:p>Crohn\u2019s disease (CD) is a multifactorial chronic disorder that involves a combination of factors, including genetics, immune response, and gut microbiota. Therapy includes salicylates, immunosuppressive agents, corticosteroids, and biologic drugs. International guidelines do not recommend the use of antibiotics for CD patients, except in the case of septic complications. Increasing evidence of the involvement of gut bacteria in this chronic disease supports the rationale for using antibiotics as the primary treatment for active CD. In recent decades, several pathogens have been reported to be involved in the development of CD, but only Escherichia coli (E. coli) and Mycobacterium avium paratubercolosis (MAP) have aroused interest due to their strong association with CD pathogenesis. Several meta-analyses have been published concerning antibiotic treatment for CD patients, but randomized trials testing antibiotic treatment against E. coli and MAP have not shown prolonged benefits and have generated conflicting results; several questions are still unresolved regarding trial design, antibiotic dosing, the formulation used, the treatment course, and the outcome measures. In this paper, we provide an overview and update of the trials testing antibiotic treatment for active CD patients, taking into account the role of pathogens, the mechanisms by which different antibiotics act on harmful pathogens, and antibiotic resistance. Finally, we also present new lines of study for the future regarding the use of antibiotics to treat patients with active CD.<\/jats:p>","DOI":"10.3390\/antibiotics13020151","type":"journal-article","created":{"date-parts":[[2024,2,5]],"date-time":"2024-02-05T03:28:29Z","timestamp":1707103709000},"page":"151","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Antibiotic Therapy for Active Crohn\u2019s Disease Targeting Pathogens: An Overview and Update"],"prefix":"10.3390","volume":"13","author":[{"given":"Gaetano","family":"Iaquinto","sequence":"first","affiliation":[{"name":"Gastroenterology Unit, St. Rita Hospital, 83042 Atripalda, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7294-8277","authenticated-orcid":false,"given":"Giuseppe","family":"Mazzarella","sequence":"additional","affiliation":[{"name":"Institute of Food Sciences, Consiglio Nazionale Delle Ricerche (CNR), 83100 Atripalda, Italy"},{"name":"E.L.F.I.D, Department of Translational Medical Science, University \u201cFederico II\u201d, 80147 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5595-7841","authenticated-orcid":false,"given":"Carmine","family":"Sellitto","sequence":"additional","affiliation":[{"name":"Section of Human Anatomy, Department of Mental and Physical Health and Preventive Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"},{"name":"Department of Medicine, Surgery and Dentistry \u201cScuola Medica Salernitana\u201d, University of Salerno, 84081 Salerno, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6435-7680","authenticated-orcid":false,"given":"Angela","family":"Lucariello","sequence":"additional","affiliation":[{"name":"Department of Sport Sciences and Wellness, University of Naples \u201cParthenope\u201d, 80100 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Melina","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, San G. Moscati Hospital, 83100 Atripalda, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Iaquinto","sequence":"additional","affiliation":[{"name":"Gastroenterology Unit, St. Filippo Neri Hospital, 00135 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3905-6154","authenticated-orcid":false,"given":"Antonio","family":"De Luca","sequence":"additional","affiliation":[{"name":"Section of Human Anatomy, Department of Mental and Physical Health and Preventive Medicine, University of Campania \u201cLuigi Vanvitelli\u201d, 80138 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vera","family":"Rotondi Aufiero","sequence":"additional","affiliation":[{"name":"Institute of Food Sciences, Consiglio Nazionale Delle Ricerche (CNR), 83100 Atripalda, Italy"},{"name":"E.L.F.I.D, Department of Translational Medical Science, University \u201cFederico II\u201d, 80147 Napoli, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1038\/s41572-020-0172-2","article-title":"Crohn\u2019s disease","volume":"6","author":"Roda","year":"2020","journal-title":"Nat. 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