Selby W, Pavli P, Crotty B et al.; Antibiotics in Crohn’s Disease Study Group.
Royal Prince Alfred Hospital, Sydney, NSW, Australia.
Gastroenterology 2007;132:2313–9.
Editor’s note: It has been suggested that
mycobacterium avium subspecies
paratuberculosis (
MAP) is a cause of Crohn’s disease (CD). This article describes a landmark double-blind, randomized, placebo-controlled clinical trial of antimycobacterial treatment for the maintenance of remission in patients with CD. A total of 213 patients from 20 centers in Australia were randomized to receive a 16-week course of clarithromycin 750mg/day, rifabutin 450 mg/day, clofazimine 50mg/day, or placebo, as well as a concurrent tapering course of prednisolone (40 mg/day reducing to zero over 16 weeks). Subjects who were in remission at the end of this induction phase continued on to the maintenance phase of the trial, during which they received either antibiotics or placebo for 104 weeks.