budesonide + ciprofloxacin + metronidazole

This is a combination therapy consisting of three active pharmaceutical ingredients:

• Budesonide: a synthetic glucocorticoid corticosteroid with potent local anti-inflammatory effects, primarily acting via glucocorticoid receptor agonism to reduce inflammation in the gastrointestinal tract.
• Ciprofloxacin: a fluoroquinolone antibiotic that inhibits bacterial DNA gyrase and topoisomerase IV, leading to inhibition of bacterial DNA replication and cell death. It is effective against many Gram-negative bacteria.
• Metronidazole: a nitroimidazole antibiotic and antiprotozoal agent that disrupts DNA synthesis in anaerobic bacteria and certain protozoa.

This combination has been studied for use in active Crohn's disease, particularly when colonic involvement is present. While the addition of ciprofloxacin and metronidazole to budesonide did not show significant benefit over budesonide alone for ileal Crohn’s disease, there may be improved outcomes for patients with colonic disease. The regimen leverages both anti-inflammatory (budesonide) and broad-spectrum antibacterial (ciprofloxacin, metronidazole) mechanisms.