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Abbreviations: N, number of subjects in trial; CD, Crohn's disease; CDAI, Crohn's disease activity index.

Abbreviations: N, number of subjects in trial; CD, Crohn's disease; CDAI, Crohn's disease activity index.

were randomized to receive rifaximin for 3 months followed by VSL#3 for 9 months or mesalamine for 12 months. At the end of the trial 20% of the patients had recurrent CD in the probiotic/antibiotic group while 40% of patients in the mesalamine group relapsed (102). In an open study of patients with mildly active CD despite 5-ASA therapy, patients were offered either steroids or a trial of Lactobacillus salivarius subsp. salivarius UCC118 for 6 weeks (104). Of the 25 patients enrolled, 19 successfully completed the study and avoided steroids for a 3-month follow-up period. The mean CDAI at enrolment was 217, falling to 150 at the end of the study period (104). Finally, in a recent study of 45 CD patients who underwent curative surgery, the recurrence rate 1 year after surgery in patients treated with Lactobacillus rhamnosus GG or placebo was compared. No difference was seen between the patients receiving probiotic (16% recurrence rate) and the placebo group (10%) (105).

In conclusion, while the trials for probiotics in treatment of IBD to date are promising, results have been mixed; consequently, better-designed trials are needed.

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