Always need anti-biotics? I would give an uneducated suggestion of NO!!!!
The only certainty is that anti-bs will make parts of your gut worse. Don't put yourself thru that. Maybe, if there is an infection in the pouches, anti-b s will be needed, but only when your life is threatened. Perhaps try to kill offending bacteria with things that will not wipe out your beneficial bacertia too, like Colloidal Silver or oregano Oil or zappers or Vit C.
Even just acifiying yourself can kill off bad bacertia.
Oxygen therapies might help your body will kill off the anerobic bacteria, whcih tend to be the bad ones.