Sequence Analysis Identifies Clusters of Antibiotic Use After the First Episode of Pouchitis in a Population-Based Study That May Represent High-Risk Phenotypes

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INTRODUCTION: 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 after an initial episode of pouchitis. DISCUSSION: High-risk phenotypes after an initial episode of pouchitis suggest the need to evaluate the role of secondary prevention strategies.