azathioprine + metronidazole

Azathioprine + metronidazole is a combination therapy consisting of two small molecule drugs used primarily in the management of inflammatory bowel diseases, particularly Crohn's disease. Azathioprine is an immunosuppressive antimetabolite that interferes with nucleic acid synthesis and impairs lymphocyte proliferation, thereby reducing immune-mediated inflammation. Metronidazole is an antibiotic effective against anaerobic bacteria and protozoa; it also exhibits immunosuppressive effects on the gastrointestinal mucosa by decreasing cell-mediated immune responses. The combination has been studied for its ability to reduce postoperative recurrence of Crohn's disease in high-risk patients, with evidence suggesting that concomitant use results in lower endoscopic recurrence rates and less severe recurrences compared to monotherapy[1][6]. This regimen may also be used in veterinary medicine for inflammatory bowel disease management[4].