I have only been rotating antibiotics for 7 months now, previously I was on only cipro for 2 years, then it stopped being as effective. I had to then rotate between cipro, bacterium, amox-clav, and keflex every week. Some have stopped being as effective after 5-6 days now and I am very nervous as what to do next as it appears they will last even fewer days in the future. Anyone had experience with this before. Thanks so much.
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Have you skipped over Flagyl for a reason? It's magic for some folks.
When single antibiotics stop working for pouchitis, Shen suggests combination antibiotics as a strategy to consider. I added Flagyl to my Cipro when the Cipro lost effectiveness (Flagyl alone never worked for me), and the combination has been working nicely for over a year.
Thanks Scott. I just started using cipro and flagil together a couple weeks ago and using for only a week but I will try to see if using both if I can go longer. Are there any others that are recommended together?
Cipro and Flagyl work well together because they come from different antibiotic families and give you greater coverage as they work on different bacteria.
If you are going to rotate you have to pay attention to what antibiotics are in the same family. For example cipro and levacquin are both fluoroquilones and never should be taken together or one after the other. I like to go from cipro and flagyl in tandem onto Xifaxin which isn't systemically absorbed and then on to Augmentin. If you added levacquin to this rotation, it would necessarily have to go between Xifaxin and Augmentin.
I have been rotating antibiotics for 20 years. They work well on the symptoms but not on the inflammation. Which is why I am going onto Remicade.
add to this mix: invanz. i used to take a bottle with 1 g of powder, add water, shake and drink it. usually it's an infusion but a doc suggested i try it this way. sort of worked, but then again nothing has been the silver bullet for me. at least it buys one time between other meds.
fyi i got extreme tendonitis, throughout entire body, from levaquin. was fortunate that it abated after i went off med. very painful and frightening so be careful.
good luck, jlh
I have the Cipro in 500 mg tabs and the Flagyl in 250 mg. I take 1 Cipro and 2 Flagyl in the morning and 1 and 2 at bedtime. Therefore, 1000 mg of each per day. As noted previously, these antibiotics work on and kill different bacteria, therefore giving you the greatest amount of coverage.
JLH- tendonitis is a possible side effect with cipro or levacquin. If you had it with levacquin I would be very careful about taking Cipro as they are in the same antibiotic family, that being the fluoroquilones. Most people, however, have no such side effects with either.
I've found that Cipro and Flagyl work just as well for me once daily as they do in two half-size doses. I take them together at bedtime, and they work fine that way for me. Since the Cipro must be spaced hours away from dairy, bedtime is more convenient for me than the morning. I worked down to the lowest effective dose. For me that's Flagyl 250 mg and Cipro 500 mg.
In addition to all the comments above, I think it would be good to try Pepto Bismol tabs and see how that works for you. I was skeptical til I used it, and it really worked just as well as any other antibiotic for me.
I was also good with Cipro alone, until I reduced it to one tablet a day and then the symptoms came back, but when I went back to 2 tablets it didn't work. So then I combined the cipro with Ceftin, which is a milder antibiotic and did the trick and worked well for me for a few years before a routine surgery triggered pouchitis again and that combo wasn't helping and now I'm still trying to find a good cocktail/combination that works again. I'm currently trying Vedolizumab, fingers crossed, but I will go back to cipro again at some point since it's the only one that I responded to well. Good luck, keep us posted on what ends up working for you. 
