Pre-treatment With Azithromycin to Reduce Immunogenicity to to Anti-TNF Agents in Patients With Crohn's Disease

Exclusion Criteria

• •Inclusion in another interventional study
• •Patients who cannot provide informed consent and do not have a legal guardian
• •Patients with perianal involvement who are expected to require antibiotic therapy for their disease
• •Patients on chronic antibiotic therapy due to any cause
• •Patients with ongoing fluid collection/abscess either internal or perianal
• •Known history of allergy to the study intervention formulation or any of its excipients or components of the delivery device
• •Prolonged QTc interval or conditions leading to additional risk for QT prolongation
• •Chronic kidney disease stage 5 (GFR \< 10)
• •Crohn's Disease complication requiring surgical treatment
• •Planned/ongoing methotrexate co-therapy
• •Fecal microbiota transplantation within 8 weeks prior to randomization
• •Participant has any disorder that, in the opinion of the investigator, may compromise the ability to participate in the study
• •Pregnancy
• •Patients who received azithromycin therapy in the previous year (we will not exclude prior use of other antibiotic therapy)
• •Patients who received any antibiotic treatment within 4 weeks prior to randomization
• •Re-induction of the same anti-TNF medication
• •Patients who are on chronic therapy which cannot be withheld in one of these medications: colchicine, phenytoin, and digoxin