They concluded that the antibiotics didn't have a sustained benefit in
treating Crohn's then went on to say: "Short-term improvement was seen
when this combination was added to corticosteroids, most likely because of
nonspecific antibacterial effects."

Corticosteroids suppress the imune system and reduce inflammation? So I
take it while they were trying to see if antibiotics would kill the
bacteria, they were simultaneously suppressing the immune system
inhibiting it from killing the bacteria.

Maybe they were using some kind of corticosteroids that don't ... oh,
nevermind.

-- Dale
<http://DaleRoose.com/>

Gastroenterology. 2007 Jun;132(7):2313-9. Epub 2007 Mar 21.

Comment in:
Gastroenterology. 2007 Jun;132(7):2594-8.
Gastroenterology. 2007 Nov;133(5):1742-3; author reply 1745-6.
Gastroenterology. 2007 Nov;133(5):1742; author reply 1745-6.
Gastroenterology. 2007 Nov;133(5):1743-4; author reply 1745-6.
Gastroenterology. 2007 Nov;133(5):1744-5; author reply 1745-6.

Two-year combination antibiotic therapy with clarithromycin, rifabutin,
and clofazimine for Crohn's disease.

Selby W, Pavli P, Crotty B, Florin T, Radford-Smith G, Gibson P, Mitchell
B, Connell W, Read R, Merrett M, Ee H, Hetzel D; Antibiotics in Crohn's
Disease Study Group.

Royal Prince Alfred Hospital, Sydney, Australia.
warwicks@...

BACKGROUND & AIMS: Mycobacterium avium subspecies paratuberculosis has
been proposed as a cause of Crohn's disease. We report a prospective,
parallel, placebo-controlled, double-blind, randomized trial of 2 years of
clarithromycin, rifabutin, and clofazimine in active Crohn's disease, with
a further year of follow-up. METHODS: Two hundred thirteen patients were
randomized to clarithromycin 750 mg/day, rifabutin 450 mg/day, clofazimine
50 mg/day or placebo, in addition to a 16-week tapering course of
prednisolone. Those in remission (Crohn's Disease Activity Index <or=150)
at week 16 continued their study medications in the maintenance phase of
the trial. Primary end points were the proportion of patients experiencing
at least 1 relapse at 12, 24, and 36 months. RESULTS: At week 16, there
were significantly more subjects in remission in the antibiotic arm (66%)
than the placebo arm (50%; P=.02). Of 122 subjects entering the
maintenance phase, 39% taking antibiotics experienced at least 1 relapse
between weeks 16 and 52, compared with 56% taking placebo (P=.054). At
week 104, the figures were 26% and 43%, respectively (P=.14). During the
following year, 59% of the antibiotic group and 50% of the placebo group
relapsed (P=.54). CONCLUSIONS: Using combination antibiotic therapy with
clarithromycin, rifabutin, and clofazimine for up to 2 years, we did not
find evidence of a sustained benefit. This finding does not support a
significant role for Mycobacterium avium subspecies paratuberculosis in
the pathogenesis of Crohn's disease in the majority of patients.
Short-term improvement was seen when this combination was added to
corticosteroids, most likely because of nonspecific antibacterial effects.