{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T19:00:22Z","timestamp":1790794822062,"version":"4.1.0"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R38AG070229"],"award-info":[{"award-number":["R38AG070229"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>A quarter of patients with ulcerative colitis who undergo total proctocolectomy with ileal pouch\u2013anal anastomosis experience chronic pouchitis. While advanced therapies (ATs) are effective in some patients, their impact on antibiotic dependence is unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In a multicenter, retrospective study, we identified adults with chronic pouchitis during treatment with AT. Those with complete pre-AT antibiotic data formed the \u201cincident AT user\u201d cohort. Those with only post-AT data formed the \u201cprevalent AT user\u201d cohort. Antibiotic prescription was modeled as percentage of time, calculated as the number of weeks of antibiotic prescription during the weeks of observed time. The pooled prevalence of antibiotic use during AT was calculated in a systematic review and meta-analysis,.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 67 incident AT users, 24 (36%) initiated treatment with tumor necrosis factor-\u03b1 antagonist, 17 (25%) with anti-integrin, 23 (34%), with interleukin (IL) inhibitors (anti-IL), and 3 (5%) with Janus kinase inhibitors. The mean time on antibiotics was unchanged from 38% to 33% after AT initiation, and 61% of patients (n\u2009=\u200944) had a reduction in antibiotic use. Compared to the patients without reduction, the reduction group had a higher proportion of patients on anti-IL (46% vs 15%, adjusted odds ratio [OR] 11.1; 95% CI, 2.12-57.62). There were no differences in disease-related parameters. Seventy-nine percent (22\/28) of prevalent AT users required antibiotics. On meta-analysis, pooled prevalence of antibiotic use was 0.46 (95% CI, 0.35-0.57).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Just over half of patients on AT for chronic pouchitis saw reduced antibiotic use; however, further studies are needed to identify impact of AT on antibiotic use and define which patients benefit from immune-mediated vs microbiome-directed therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ibd\/izag086","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:46:11Z","timestamp":1779882371000},"page":"1910-1918","source":"Crossref","is-referenced-by-count":0,"title":["Impact of advanced therapy initiation on antibiotic dependence in chronic pouchitis"],"prefix":"10.1093","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6595-1101","authenticated-orcid":false,"given":"Yushan","family":"Pan","sequence":"first","affiliation":[{"name":"Department of Medicine, Massachusetts General Hospital , Boston, MA 02114,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katie A","family":"Dunleavy","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Crohn\u2019s and Colitis Center, Massachusetts General Hospital , Boston, MA 02114,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9436-1821","authenticated-orcid":false,"given":"Ashwin N","family":"Ananthakrishnan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Crohn\u2019s and Colitis Center, Massachusetts General Hospital , Boston, MA 02114,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"2026093014392278900_izag086-B1","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1053\/j.gastro.2013.07.041","article-title":"Risk of surgery for inflammatory bowel diseases has decreased over time: a systematic review and meta-analysis of population-based studies","volume":"145","author":"Frolkis","year":"2013","journal-title":"Gastroenterology"},{"key":"2026093014392278900_izag086-B2","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1097\/dcr.0000000000002037","article-title":"The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for the surgical management of ulcerative colitis","volume":"64","author":"Holubar","year":"2021","journal-title":"Dis Colon Rectum"},{"key":"2026093014392278900_izag086-B3","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.cgh.2022.04.015","article-title":"Increasing incidence of pouchitis between 1996 and 2018: a population-based Danish cohort study","volume":"21","author":"Barnes","year":"2023","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026093014392278900_izag086-B4","doi-asserted-by":"publisher","first-page":"1583","DOI":"10.1016\/j.cgh.2020.06.035","article-title":"Incidence, risk factors, and outcomes of pouchitis and pouch-related complications in patients with ulcerative colitis","volume":"19","author":"Barnes","year":"2021","journal-title":"Clin Gastroenterol Hepatol"},{"key":"2026093014392278900_izag086-B5","doi-asserted-by":"publisher","first-page":"679","DOI":"10.1097\/SLA.0b013e31827d99a2","article-title":"Ileal pouch anal anastomosis: analysis of outcome and quality of life in 3707 patients","volume":"257","author":"Fazio","year":"2013","journal-title":"Ann Surg"},{"key":"2026093014392278900_izag086-B6","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1038\/s41575-024-00920-5","article-title":"Pouchitis: pathophysiology and management","volume":"21","author":"Shen","year":"2024","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"2026093014392278900_izag086-B7","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1053\/j.gastro.2023.10.015","article-title":"AGA clinical practice guideline on the management of pouchitis and inflammatory pouch disorders","volume":"166","author":"Barnes","year":"2024","journal-title":"Gastroenterology"},{"key":"2026093014392278900_izag086-B8","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1056\/NEJMoa2208450","article-title":"Vedolizumab for the Treatment of Chronic Pouchitis","volume":"388","author":"Simon","year":"2023","journal-title":"N Engl J Med"},{"key":"2026093014392278900_izag086-B9","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1080\/00365521.2019.1569718","article-title":"Adalimumab in the treatment of chronic pouchitis. 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