The effect of anti-TNF on the human microbiota has been studied previously, primarily due to the infectious complications caused by these agents, as inhibiting the TNFα pathway increases the risk of several infectious diseases [tuberculosis, listeriosis, aspergillosis, coccidioidomycosis, histoplasmosis, or salmonellosis].38 However, only a few studies have focused on changes following anti-TNF therapy in IBD. This evidence concerns the gene TNF and coccidioidomycosis.