Short-Term Antibiotic Success but Long-Term Challenges in Pouchitis: Insights into Microbial Strain Dynamics and Virulence Re-Emergence

Highlight

• Antibiotic therapy induces rapid but transient remission in pouchitis by reducing exotoxin-producing bacteria.
• Antibiotic resistance gene abundance increases during treatment, driven by expansion of pre-existing resistant strains.
• Virulent bacterial strains re-emerge post-treatment, contributing to relapse of pouch inflammation.
• Long-term management requires targeted strategies beyond broad-spectrum antibiotics to achieve sustained microbial control.

Study Background