Which statement describes antibiotic use in the management of Crohn's fistulas?

• A. Antibiotics are never used
• B. Antibiotics may be used for abscess and draining fistulas in addition to anti-inflammatory therapy
• C. Antibiotics alone are curative
• D. Antibiotics are used only post-surgery

Answer: (B)

Antibiotics in Crohn’s fistulas are used as part of a broader treatment plan to control infection and inflammation when a fistula or abscess is present, not as the sole solution. They help reduce bacterial load and local inflammation, which supports drainage procedures and anti-inflammatory or biologic therapies in promoting fistula healing. Common regimens target anaerobic and enteric bacteria and are chosen to work alongside drainage of abscesses and ongoing anti-inflammatory treatment, rather than replacing them. This approach recognizes that while antibiotics can aid healing, most fistulas in Crohn’s disease require additional steps such as drainage and often surgical or biologic interventions for durable control.