Does anyone take just flagyl as treatment for pouchitis, or is it always in addition to another drug like cipro or levaquin? I seem to remember having success with just flagyl a few times through the years, but then needing levaquin. I'm not sure I have pouchitis, may just be a bug, or the water I have been drinking. But if it gets worse, I'll have to start on flagyl and see. I thought I remember hearing that flagyl works on aerobic bacteria and levaquin/cipro on the anaerobic, or vice versa. Basically, do I need both?

I can only recall needing antibiotics for pouchitis once. I used only one or the other. I don't remember with certainty which medication was utilized but somehow I think it was Flagyl.

The short answer is you need what works for you. A lot of people have been prescribed both at the same time but personally I think that's overkill. The general progression is Flagyl then Cipro then Rifaximin then it gets complicated.

Tolerance does become an issue. Flagyl and cipro eventually both lost effectiveness for me which is why I'd advise taking one at a time if you can get away with it. If you can't, then double up.

I was prescribed just Flagyl at first for my pouchitis. When it failed to work I went on Flagyl/Cipro combo. Now with a relapse I'm only taking Cipro.

Well they treat two different bacteria. For pouchitis I'd use cipro to sterilize your pouch. It will not kill c diff however, and c diff is common when you've been on antibiotics for a while. So take a full course of both and when complete hit the VSL3 hard for a couple of weeks.

Good luck

Jim

Jim. Good points. I've heard that different antibiotics treat different things. Aerobic and anaerobic, depending on the bacteria. I've had the pouch almost 12 years, and overall have been pretty lucky. Medicine has seemed to work. I think I got off Levaquin because of all the info out there about what it does to ligaments. It seems I always pulled a muscle when I was on it. Cipro did not sit well with me. I see a GI doc tomorrow, and will talk to him about going back on Levaquin. Even with insurance it is expensive, but better than being sick.

I've only ever been prescribed Flagyl for pouchitis. I'm taking 500mg 3x/day right now

I take both Flagyl and Diflican. I was prescribed antibiotics before, but never have had a bacterial infection. I get pouchitis multiple times a year. At least once a year I am in the hospital for it. The first few times I had it, I was hospitalized and misdiagnosed. After about 4 days the flare up seems to end. My big issue is the pain with it.

So for followups and learning. The surgeon (in Atlanta), Dr. Orangio, who I found on this site, was great. He inspired 100 percent confidence. Scoped and found bad pouchitis. Put me on 30 days Flagyl and 30 days Levaquin. A lot more than I've taken in the past, but I'll take his word for it. I started feeling better within 24 hours. Medicine in America is amazing. I'm still weak from the episode, but no symptoms. One note. I got a flu shot a few days before things got bad. I think it really caused more problems in terms of exhaustion. Usually pouchitis does not knock me out this bad. Thanks for the advice.

I have chronic pouchitis and I am also allergic to Cipro (anaphylactic reaction.) I take flagyl to keep the pouchitis in check - 500 mg - 750 mg per day. My doctor advises keeping it 1000 mg/day or less because higher doses can cause long-term neuropathy. If I do get a bad flare up, I will increase to 1500 mg (500 mg 3x per day) for 2 weeks, then drop down to the 500 mg per day maintenance. This has been working fairly well for me, except when I tried going down to 250 mg/day ... that was a mistake. I also started taking 1-2 pepto bismol chewables per day -- that seems to be helping quite a bit. I'm hoping that my luck with Flagyl continues.

I've taken flagyl plenty of times just by itself admit worked fine in the beginning but lost effectivness even though i was cycling between other antibiotics. Got to love a drug which has a warning label that says it may cause cancer, is listed by the us national toxicology program as reasonably anticipated to be a human carcinogen, and is banned from veterinary use in the us and eu. But its ok for long term treatment of pouchitis as is its twin sibling tindamax.