Sequence Analysis Identifies Clusters of Antibiotic Use after the First Episode of Pouchitis in a Population-based Study that May Represent High-Risk Phenotypes

OBJECTIVE: Evaluate antibiotic patterns in the 12 months after an initial episode of pouchitis and associated factors. METHODS: In a population-based cohort, we identified the first episode of pouchitis (within 12 months of ileal pouch-anal anastomosis surgery) and used sequence analysis to identify antibiotic treatment patterns in the subsequent 12 months. RESULTS: Among 662 patients, we identified 4 clusters of antibiotic prescribing patterns, corresponding to patterns of intermittent and chronic pouchitis. Patients with chronic antibiotic-dependent pouchitis received antibiotics in most intervals following an initial episode of pouchitis. CONCLUSIONS: High risk phenotypes following an initial episode of pouchitis suggest the need to evaluate the role of secondary prevention strategies.