Pharmacotherapy used in anal fistula depends upon the location and symptoms of patient. Antibiotics are used in patient with comorbities like immunosuppression, diabetes, extensive cellulitis, prosthetic devices and high risk cardiac patients. Antipyretics and analgesic for symptomatic relief of pain and fever. Treatment of underlying causes is important to treat recurrent anal fistulas.

• Empiric therapy for anal fistula depends on following factors:^[1]
  • Location of anal fistula.
  • If the patient shows signs and symptoms of abscess.
• Main stay of therapy is surgical management but antibiotics are given in the following condition:^[2][3]
  • Immunosuppression
  • Diabetes
  • Extensive cellulitis
  • Prosthetic devices
  • High-risk cardiac patient
• Other drugs used for symptomatic relief of anal fistula are:
  • Antipyretics and analgesics like acetaminophen, and Ibuprofen.

• Treatment of anal fistula with Crohn’s diseases:
  • Anti-tumour necrosis factor α antibody, infliximab is the first line of treatment.^[4][5][6]
• Treatment of anal fistula with tuberculosis:^[7][8]
  • If the patient is having recurrent fistula and fail to respond to standard therapy then, tuberculosis should be suspected.
  • Anti-tuberculous drugs are the first line treatment.