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 are efficacious in CD and UC. 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: 1) reducing the concentration of bacteria and fungi in the intestine of patients with IBD; 2) changing the composition of the intestinal flora and promoting the growth of probiotic bacteria; 3) reducing tissue invasion by intestinal bacteria and treating some microabscesses. Antibiotics are not commonly used in the treatment of U C. There are several controlled pilot studies using antibiotics in the treatment of UC patients, but the results are inconsistent. It is generally accepted that antibiotics have little therapeutic value in active U C, but they do have value in fulminant colitis complicated by abscesses or the development of toxic megacolon. Broad-spectrum antibiotics should still be used, especially if these patients are also receiving corticosteroids. 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 only temporarily alter the concentration of intestinal bacteria, and the bacteria will reassemble 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.