{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T09:11:13Z","timestamp":1790673073039,"version":"4.1.0"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T00:00:00Z","timestamp":1631923200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"DOI":"10.13039\/100007028","name":"Leona M. and Harry B. Helmsley Charitable Trust","doi-asserted-by":"publisher","award":["2015PG-ISL020"],"award-info":[{"award-number":["2015PG-ISL020"]}],"id":[{"id":"10.13039\/100007028","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,7,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Pouchitis, often developing after colectomy and ileal pouch-anal anastomosis for ulcerative colitis, is highly responsive to antibiotics. Ciprofloxacin and\/or metronidazole are commonly used, often for prolonged periods. We report patterns of antibiotic use, adverse events, and resistant infections in patients with pouchitis with long-term antibiotic treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In a cohort of patients following pouch surgery, a retrospective nested case-control analysis was performed between 2010 and 2017. Ultra-long-term use, defined as the top 10% of users, was compared with the remaining users. Patterns of antibiotic use, adverse events, and resistant infections were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The cohort included 205 patients with UC, of whom 167 (81.5%) used antibiotics for pouchitis, predominantly ciprofloxacin. The long-term antibiotic use rate was 18% and 42% at 5 and 20 years postsurgery, respectively. Mean antibiotic use of at least 1, 3, and 6 months\/year was noted in 54 (26.3%), 31 (15.1%), and 14 (6.8%) patients, respectively. Twenty-two (13.2%) and 4 (2.4%) patients reported mild and severe (transient) adverse events, respectively, without mortalities, tendinopathies or arrhythmias. Adverse event rates for ciprofloxacin and metronidazole were 1per 10,000 and 6 per 10,000 use-days, respectively. Longer, but not ultra-long antibiotic use, was associated with mild adverse events. There was no association between antibiotic use and resistant infections. Thirteen (6.3%) patients required ileostomy procedures\u2014more commonly in the ultra-long-term antibiotic users.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Patients with pouchitis may require prolonged antibiotic treatment, reflecting clinical benefit and favorable safety profile. Few adverse events and resistant infections were observed with long-term antibiotics use. However, resistant microbial strains selection, which are potentially transmittable, warrants consideration of different therapeutic alternatives.<\/jats:p><\/jats:sec>","DOI":"10.1093\/ibd\/izab209","type":"journal-article","created":{"date-parts":[[2021,9,18]],"date-time":"2021-09-18T13:21:10Z","timestamp":1631971270000},"page":"1027-1033","source":"Crossref","is-referenced-by-count":21,"title":["Long-term Antibiotic Treatment in Pouchitis\u2014Patterns of Use and Safety"],"prefix":"10.1093","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6148-5668","authenticated-orcid":false,"given":"Nir","family":"Bar","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoav","family":"Avraham","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vadim","family":"Dubinsky","sequence":"additional","affiliation":[{"name":"School of Molecular Cell Biology and Biotechnology, George S. Wise Faculty of Life Sciences, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel A","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy A","family":"Weiss","sequence":"additional","affiliation":[{"name":"Celiac Disease Program, Vatche and Tamar Manoukian Division of Digestive Diseases, University of California Los Angeles , Los Angeles, California , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lian","family":"Banon","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"},{"name":"Internal Medicine H, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hagit","family":"Tulchinsky","sequence":"additional","affiliation":[{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"},{"name":"Colorectal Unit, Department of Surgery, Tel Aviv Medical Center , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nitsan","family":"Maharshak","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, Tel Aviv Sourasky Medical Center , Tel Aviv , Israel"},{"name":"Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv , Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5129-5652","authenticated-orcid":false,"given":"Uri","family":"Gophna","sequence":"additional","affiliation":[{"name":"School of Molecular Cell Biology and Biotechnology, George S. 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