P1044 Effectiveness of adjunctive use of antibiotics in Acute Severe Ulcerative Colitis
Authors: Hyun H K , Park J , Park S J , Park J J , Kim T I , Cheon J H 
Published: January 2025

Background

The etiology of ulcerative colitis (UC) remains uncertain, potentially involving an immune response to unidentified bacterial pathogens or gut microbiota. The use of antibiotics in treating acute severe UC (ASUC) is controversial. This study aims to evaluate the therapeutic benefit of adding antibiotics to corticosteroids in the management of ASUC.

Methods

In this retrospective study included patients with ASUC who met diagnostic criteria of Truelove and Witts at admission and received intravenous corticosteroid, with or without adjuvant antibiotics. The outcomes of interest included the need for medical and surgical rescue therapy during hospitalization, and re-admission as well as at 1 week, 3 months, and 1 year. Propensity score matching (PSM) was performed to assess whether adjunct antibiotics influenced clinical outcomes.

Results

Of the 386 patients screened, 222 met the inclusion criteria. Among them, 75 patients (33.6%) received IV corticosteroids alone, whereas 147 patients (66.4%) were administered a combination of IV corticosteroids and antibiotics. After PSM, the combination of IV corticosteroids and antibiotics did not significantly alter the need for in-hospital medical rescue therapy, re-admission or clinical response based on the Mayo score at 1 week of hospitalization (p=0.159). Additionally, no significant differences were observed in the rates of medical rescue therapy, re-admission or UC-related surgery at 3 month (p=0.749) or 1 year (p=0.969).

Conclusion

In patients with ASUC, there was no statistically significant difference in outcomes between treatment with IV corticosteroids alone and the combination of IV corticosteroids with antibiotics.

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