Inflammatory bowel disease (IBD) mainly includes Crohn’s disease (CD) and ulcerative colitis (UC). Although antibiotics are commonly used clinically to treat IBD, there is no conclusive evidence to date that antibiotics can be effective in CD and UC. Hong Zifu, Department of Anorectal Medicine, Guang’anmen Hospital, Chinese Academy of Traditional Chinese Medicine The clinical use of antibiotics for the treatment of IBD is based on studies showing that bacteria in the intestinal lumen play an important role in the pathogenesis of IBD. It is hypothesized that antibiotics can influence the regression of IBD by (i) reducing the concentration of bacteria and fungi in the intestine of IBD patients; (ii) changing the composition of intestinal flora and promoting the growth of probiotic bacteria; and (iii) reducing the invasion of tissue by bacteria in the intestine and treating some microscopic abscesses. For ulcerative colitis (UC). Antibiotics are not commonly used in the treatment of U C. There are several controlled pilot studies using antibiotics in the treatment of patients with UC, but the results are inconsistent. Antibiotics are generally considered to have little to no therapeutic value in active U C. However, antibiotics may be of value in fulminant colitis complicated by abscesses or the development of toxic megacolon. In particular, broad-spectrum antibiotics should be used when these patients are also receiving corticosteroids. For Crohn’s disease (CD). The relationship between antimicrobial indicators and efficacy of antimicrobial drugs is unclear, and it is uncertain whether efficacy studies of a particular antibiotic can be applied to other antibiotics. Most antibiotics can only temporarily alter the concentration of intestinal bacteria, and the bacteria will re-accumulate on the mucosa after treatment is completed. Therefore, drugs such as metronidazole and ciprofloxacin are commonly used as effective complementary therapeutic agents. Reported studies have shown that antibiotics are effective in treating patients with CD, and according to several experts, the application of antibiotics for CD can be a more reasonable treatment as a first-line treatment or in combination with immunosuppressive agents. This hypothesis is further confirmed by the results of recent studies, which indicate that long-term application of nitroimidazole or clofazimine is effective in patients with CD. However, there are still many questions that need to be addressed, and in the future, if they are resolved, better treatment strategies can be developed for the etiology of the disease. Therefore, it is important to come to the hospital for further examination before deciding on the medication for inflammatory bowel disease. Do not use antibiotics casually as this may delay the disease and disturb the normal intestinal microenvironment.