resistant c-diff/vancomycin question - Mothering Forums

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#1 of 16 Old 05-08-2008, 11:29 PM - Thread Starter
 
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When Dakota was in the hospital for her T&A she ended up contracting c-diff. They started her on Flagyl and made it sound as if this would clear things up and that it wasn't that big of a deal. Having been in the NICU the nurses always spoke of c-diff as this dreaded awful, hard to get rid of problem so I was skeptical. We did 10 days of Flagyl and saw no improvement and worsening distention and pain. Our GI switched us to oral Vancomycin (90mg BID) for 14 days and also put us on Floraster kids probiotics. We're 6 days into the Vancomycin and seeing no improvement and today was the worst we've had in over a week in terms of diarrhea. Our home health nurse who works at the hospital said that oral Vancomycin rarely works and that it's usually IV. Dakota's had 10 courses of Vanc and this is the first one that's oral. Anyone else have experience with c-diff? What do they do if the oral Vanc doesn't work? We were told that we'd see improvement within 3 days and our GI was less than optimistic when I told him we had seen no improvement so far.
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#2 of 16 Old 05-08-2008, 11:50 PM
 
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My ds got c diff and then I caught it from him. Flagyl made both of us even sicker. I spoke to the compounding pharmacist who said that he had seen a lot of cancer patients have success with a probiotic called VSL#2 or 3...I can look it up if you are interested.

We were told flagyl and then vancomycin IV.

The VSL worked very quickly. When he had a recurrence, it worked well again.

C. diff feels soooo horrid.
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#3 of 16 Old 05-08-2008, 11:59 PM - Thread Starter
 
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My ds got c diff and then I caught it from him. Flagyl made both of us even sicker. I spoke to the compounding pharmacist who said that he had seen a lot of cancer patients have success with a probiotic called VSL#2 or 3...I can look it up if you are interested.

We were told flagyl and then vancomycin IV.

The VSL worked very quickly. When he had a recurrence, it worked well again.

C. diff feels soooo horrid.
Flagyl seemed to make her worse as well which is why I kept questioning the attending in the hospital about when she was supposed to get better. The GI was never called while we were in-patient which is a whole other story. He's mildly ticked off to put it lightly. We weren't even on probiotics while in the hospital but our GI is really partial to these specific probiotics because they're supposed to be good for c-diff he said? I don't know why but I'd be more than happy for more information on the ones you're talking about. I'm just hoping that over the next week we'll be seeing improvement because I think IV is the next route.
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#4 of 16 Old 05-09-2008, 12:04 AM
 
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Well, we were told the opposite. Andrew was on IV Vanc and they told us if his culture was positive they had to add oral vanc in because IV couldn't get into his colon. That makes sense to me as the IV wouldn't pass through the gastro tract. In fact, I'm certain they don't IV vancomycin for c. diff. Maybe they were talking IV Flagyl?

I agree with florastor. I add in culturelle too or maybe VSL3--one of those with the florastor. The general probiotics you see for c. diff are the florastor and culturelle though I've heard of VSL#3 and I think Nicole on this board used that with her son. High, frequent doses of both a few hours after each vancomycin dose. Assume each antibiotic dose wipes out all the probiotics you did prior to it. And when the antibiotic is done you want to keep doing those probiotics. If the first round of vancomycin fails I think they'll re-dose it. Generally, though, it is the last course of treatment. And by day 6 I do think you should be seeing improvement. I'm sorry. I hope the probiotics make a difference. There is at least one other med too they can add to it if I remember right though I can't remember the name. If Vancomycin (and that combo) fail it gets very hard. One option is fecal transplants. But first I think they'll re-try either vanc or flagyl or both along with lots of probiotics. So there are things to do if it doesn't work. There are groups out there just for c. diff.

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#5 of 16 Old 05-09-2008, 12:05 AM
 
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VSL#3 The Living Shield
450 billion bacteria per sachet.

We were supposed to give him (he was about 17 lbs) 1/2 a pkg once a day.

It's manufactured by Sigma-Tau Pharmaceuticals and considered a medical food.
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#6 of 16 Old 05-09-2008, 12:09 AM - Thread Starter
 
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One option is fecal transplants. But first I think they'll re-try either vanc or flagyl or both along with lots of probiotics. So there are things to do if it doesn't work. There are groups out there just for c. diff.
I hope it doesn't get to that point. I really have no idea what the GI is going to say on Monday. I have had a hard time finding people who have experience with kids who contract c-diff it seems most people know of older people. I don't know if that makes a difference or not though.
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#7 of 16 Old 05-09-2008, 12:15 AM
 
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My guess is that I was given erroneous information or that the IV vanc was to treat something systemic in addition to the c. diff.

Emily, are you at a children's hospital? I'm surprised that they are surprised b/c I was told it is quite common among kids who are frequently on antibiotics, or even just one exposure.

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#8 of 16 Old 05-09-2008, 12:16 AM
 
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Emeric has had resistant C-diff nearly his entire life. Antibiotics didn't help. He's been taking VSL #3 for months and we've seen improvement.

Nicole, mom of 3. Mitochondrial Disease.: Epilepsy
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#9 of 16 Old 05-09-2008, 12:18 AM - Thread Starter
 
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My guess is that I was given erroneous information or that the IV vanc was to treat something systemic in addition to the c. diff.

Emily, are you at a children's hospital? I'm surprised that they are surprised b/c I was told it is quite common among kids who are frequently on antibiotics, or even just one exposure.

We were at a children's hospital but they have VERY low rate of c-diff. They've only had one case in the last 6mos other than Dakota.
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#10 of 16 Old 05-09-2008, 12:19 AM - Thread Starter
 
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Emeric has had resistant C-diff nearly his entire life. Antibiotics didn't help. He's been taking VSL #3 for months and we've seen improvement.
So did you guys do Flagyl and then Vanc and not see any improvement? Was he having a lot of distension, pain, dehydration? Did your GI consider any other steps after the abx other than the probiotics?
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#11 of 16 Old 05-09-2008, 12:20 AM
 
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We were at a children's hospital but they have VERY low rate of c-diff. They've only had one case in the last 6mos other than Dakota.
Let me know if you need names of anyone in a bigger city near you, okay?

I'm guessing b/c the hospitals here treat so many cancer patients, they see a lot more c. diff.
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#12 of 16 Old 05-09-2008, 12:34 AM - Thread Starter
 
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Let me know if you need names of anyone in a bigger city near you, okay?

I'm guessing b/c the hospitals here treat so many cancer patients, they see a lot more c. diff.
We're in one of the largest city's in TX that treats a pretty high number of cancer kids it's just got a low infectious rate. The attending may have very well been speaking of kids on the respiratory unit alone. I don't know.
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#13 of 16 Old 05-09-2008, 12:40 AM
 
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Since I'm Houston, I figured it was safe to say larger city.

It's cool that they have such a low rate. I wonder how they manage to do that.
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#14 of 16 Old 05-09-2008, 12:55 AM - Thread Starter
 
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Since I'm Houston, I figured it was safe to say larger city.

It's cool that they have such a low rate. I wonder how they manage to do that.
No doubt that Texas Children sees more c-diff cases but I just assumed (and maybe I'm wrong here) that they would know how to treat it here. We do have everything set up to schedule an appointment at TX Childrens with one of their GIs but I've been putting it off.
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#15 of 16 Old 05-09-2008, 01:00 AM
 
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You should PM me. Or maybe I should PM you.

I was actually thinking of the big cancer hospital here.

We only very minimally use TCH anymore.
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#16 of 16 Old 05-09-2008, 10:33 AM
 
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I can't offer iny input on the c-diff, but both of my kids who have gastronintesinal issues where they had bad strains of bacteria, such as clostridia, were on flagyl and vanco. Flagyl is an antibiotic that will spare some of the gut flora while vanco is like an atomic bomb that completely wipes all good and bad bacteria out.

It is vitally important that with both of these you want to take a probiotic. You want to make sure you administer it no sooner that 2 hours after you five the antibiotic. If you administer it w/in the 2 hr time frame, the antibiotic will kill off the good bacteria.

With regards to the diarrhea. I think your child might be suffering from either yeast or bacterial die off. If the vanco has wiped out all good and bad bacteria in the gut, that usually leaves various forms of yeast and fungus population to grow in abnormally large numbers if you are not giving good bacteria to keep their population down. Yeast overgrowth results in irritable behavior, bloated belly, frequent urination, loose and runny stools (even explosive stools), discoloration of stools, undigested food, dark rings under eyes, eczema or some other rash (such as ring worm), etc.

Another option is to ask the doc to prescribe an antifungal that you can take at the same time to prevent the yeast and fungus overgrowth if the probiotics are not helping.

With my personal experience, we found that if we used flagyl, we ended up having to use it 2-3 times w/ an antifungal. When we used vanco, it was for 2 weeks w/ the antifungal. We were able to eliminate our bad bacteria in one shot.

Hope this info helps.
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