Antiinflammatory effects of enterically coated amoxicillin-clavulanic acid in active ulcerative colitis

Inflamm Bowel Dis. 1998 Feb;4(1):1-5. doi: 10.1097/00054725-199802000-00001.


The inflammatory activity of colonic mucosal lesions may be stimulated by intraluminal bacteria. Our aim was to investigate whether administration of broad-spectrum antibiotics decreases inflammatory activity in ulcerative colitis. To this end, we performed a randomized, 5-day study with either oral enterically coated amoxicillin-clavulanic acid (1 g + 250 mg, t.i.d.); i.v. methylprednisolone (40 mg/day) and oral placebo (t.i.d.); or both i.v. methylprednisolone and oral amoxicillin-clavulanic acid as above, in 30 patients with clinically active ulcerative colitis. Before and after 5 days of treatment, intestinal inflammation was assessed by the quantification of mucosal release of eicosanoids and interleukin-8 by rectal dialysis in each patient. Breath H2 excretion after oral lactulose was determined as an index of metabolic activity of colonic flora. The total release of (IL-8) interleukin-8 and eicosanoids significantly decreased in patients treated with antibiotic or steroids and antibiotic. Antibiotic treatment, but not steroids, markedly inhibited breath H2 excretion. In conclusion, short-term treatment with enteric-coated amoxicillin-clavulanic acid decreases the intraluminal release of IL-8 and other inflammatory mediators.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Amoxicillin-Potassium Clavulanate Combination / administration & dosage*
  • Anti-Inflammatory Agents / therapeutic use
  • Colitis, Ulcerative / drug therapy*
  • Colitis, Ulcerative / immunology
  • Drug Therapy, Combination / administration & dosage*
  • Eicosanoids / metabolism
  • Female
  • Humans
  • Interleukin-8 / metabolism
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Tablets, Enteric-Coated


  • Anti-Inflammatory Agents
  • Eicosanoids
  • Interleukin-8
  • Tablets, Enteric-Coated
  • Amoxicillin-Potassium Clavulanate Combination
  • Methylprednisolone