I have had mild to moderate pouchitis over the years and had good results with 21 day rounds of Flagyl. Some use Cipro. Or a combo of Cipro and Flagyl.

People seem to respond differently. Flagyl alone didn't work for me, but Cipro was magic for a few years. Xifaxan (rifaxamin) didn't work for me, but others swear by it (it's quite expensive). Other options include Levaquin (like Cipro), Tindamax, Augmentin, and perhaps doxyxycline.

For me the combo or "cocktail" of Cipro and Flagyl works best. I tolerate both of them well, whereas many people seem to have side effects with one or the other.

Cannot do Flagyl. After 2 doses, intractable nausea and vomiting. Have tried 3 different times, and end up with the same result every time.

Tolerate Cipro when necessary.

For my son - he is now on rifaximin. We first tried it twice at lower doses and it did not work. Then tried higher than normal dose ( 2200 a day combined with cipro, weaned off cipro,then weaned down to low dose of rifaximin and it worked. Rifaximin is a safer so glad to have that working but Cipro always worked well. Augmentin worked for a while and then stopped working. Doxyclyine worked once too.

Levaquil & Rifaxin alternate, with 2 weeks on an AB, then a week off. Tried augmentin for 10 days not long ago and it worked also. Tried to go 2 weeks without antibiotic-didn't work.

I've been on Rifaximin since July with good results. Docs say I can stay on it pretty much indefinitely.

All of these have worked well for me at one time or another. They have all 100% sucessfully treated my pouchitis symptoms. I have always taken one at a time (some in roatation, some not), never two at once.

Cipro (took for 5 months alone...no longer effective)
Augmentin (took for 18 months alone...no longer effective)
Pepto Bismol (took for 18 months alone...no longer effective)
Flagyl (been taking in rotation for 15 months...still works)
Xifaxin (been taking for several months in rotation...still works)
Prednisone(have done a 10 day pack a couple of times as well as for 3 months...still works)

I'm trying to get the oil of oregano down in my rotation. Haven't figured it out entirely yet.

i have rotated various antibiotics..at first years ago one month on each but that has changed over the years changing every two weeks..presently ..levaquin,reflex,tinderbox,augmentin

 

xifaxin does not wok for me..

I am also on antibiotics switching from flagyl, cipro, and levequin. If I stop my symptoms return.  I am curious of the amount you take.  I take one 225mg a day alternating monthly.I am finding that the flayle in not working the way it did.  I am going to jot down the other anti- biotics that some of you have mentioned and ask my doctor about those.  Thanks  Grace

Grace-

 

Cipro and Levacquin are very similar and are from the same antibiotic family which is known as the fluorquinolone antibiotics.  For this reason you should either replace the levacquin with a non-fluoquinolone antibiotic or space it in your rotation, in other words don't go directly from cipro to levacquin.  I was given this advice a long time ago by one of my doctors.  The two antibiotic are very similar and work on the same bacteria and therefore it's not really rotating as it would be going to xifaxin or flagyl or a totally different antibiotic.  I agree that rotating is a good idea but you have to be careful with how and what you are rotating.  As Rebe mentioned I have also had to adjust the intervals of my rotation and the antibiotics I am using and the dosages.

grace i concur with CT..using two antibiotics of same family not recommended..change leviquin or cipro for another..and dosages change as does my time for rotating..its a never ending change,change,change..

 

when your present system does not work you go to a new plan of rotating..sometimes (most times) i have had to be on full allowed dosages of each antibiotic(in case of levaquin that means two ..500mg a day..)presently experimenting with 1/2 dosage of each one with the added herbs i am taking..but that is still rather new so not sure  if that will continue or where it will go

 

however my hope is herbs work and even if not always it would be good if i could get respite from antibiotics because the longer i am away from them the better they work again...

 

 

I too have taken both cipro and flagyl 

Rachel, when I took 250mg 3 times a day, I too was nauseous and did not feel well. When I reduced it to 2 times a day, I felt fine. If that is too much, you can even try one. My GI gave me this advice.

Xifaxan is my mirircle drug right now although to get it working this time around I had to first kick start it with a round of augmentum. 

Thank you all for your input     Grace

thanks again

cipro and flagyl were always used in combination for pouchitis.

others have tried no antibiotics, rather, high doses of probiotics only.

either way, a 10 day course is needed to see if it helps.