Resistant microbiome underlies antibiotic therapy in pouchitis

Pouchitis developing after total proctocolectomy and ileal pouch anal anastomosis in patients with ulcerative colitis is usually treated with antibiotics. Patients often develop antibiotic dependent or refractory disease and may be treated with antibiotics for prolonged periods. The mechanisms of response to antibiotic treatment in pouchitis and the effects on bacterial communities are mostly unknown. In this study we investigated the microbial factors that underlie the response to antibiotic treatment for pouchitis and why patients tend to develop antibiotic dependence.