title: Short article: Successful faecal coliform sensitivity-based oral ertapenem therapy for chronic antibiotic-refractory pouchitis: a case series.
abstract: Pouchitis is a common complication of restorative proctocolectomy for ulcerative colitis, and a proportion of patients develop a refractory course. The treatment of chronic antibiotic-refractory pouchitis (CARP) is challenging, and treatment failure is often a cause of pouch excision. We report on a series of three patients with CARP who were treated with oral ertapenem following faecal coliform sensitivity testing. There was an improvement in the pouchitis disease activity index in all three patients [pretreatment pouch disease activity index, median 13 (range: 10-14); post-treatment pouch disease activity index, median 1 (range: 1-3)]. Identification of faecal coliform sensitivity and treatment with oral ertapenem might be helpful in patients with CARP.
authors.affiliation: Departments of aGastroenterology bColorectal Surgery cPathology dMedical Microbiology, Royal Liverpool University Hospital, Liverpool, UK.
authors.forename: Venkata
authors.initials: V
authors.lastname: Madirrala
authors.forename: Paul
authors.initials: P
authors.lastname: Rooney
authors.forename: Richard M
authors.initials: RM
authors.lastname: Heath
authors.forename: Fiona
authors.initials: F
authors.lastname: Campbell
authors.forename: Timothy
authors.initials: T
authors.lastname: Andrews
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Neal
authors.forename: Sreedhar
authors.initials: S
authors.lastname: Subramanian
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002908:Chronic Disease; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000601:surgery*; D024901:Drug Resistance, Multiple, Bacterial; D016099:Endoscopy, Gastrointestinal; D004755:Enterobacteriaceae / Q000187:drug effects* / Q000302:isolation & purification / Q000472:pathogenicity; D000077727:Ertapenem; D005243:Feces / Q000382:microbiology*; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D019449:Pouchitis / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D016737:Proctocolectomy, Restorative / Q000009:adverse effects*; D016896:Treatment Outcome; D047090:beta-Lactams / Q000008:administration & dosage*
chemical_list: D000900:Anti-Bacterial Agents; D047090:beta-Lactams; D000077727:Ertapenem