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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can C. Difficile Infection Be Treated?

I had back surgery and obtained a staff infection. I have had 5 admits in last 9 weeks due to back and also c diff due to being on at least 4 antibiotics. I am on vanco twice a day but is there a better option as I don’t feel better with cramping,lose stool and night sweats. Is there a better option of meds? Inpatient I was on vanco oral 10 days and just started vanco again oral Friday.
Fri, 11 May 2018
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General & Family Physician,  's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Pseudomembranous enterocolitis is caused by an overgrowth of Clostridium difficile in patients who have been on antibiotics. Any antibiotic can do it. Clindamycin was the first one described, and, currently, Cephalosporins. The most common cause is profuse watery diarrhea, crampy abdominal pain, fever, and leukocytosis.

Diagnosis is best made by identifying the toxin in the stool. Stool cultures take too long, and the pseudomembranes are not always seen on endoscopy. The culpable antibiotic should be discontinued, and no antidiarrheals should be used.

Metronidazole is the treatment of choice (oral or IV), with vancomycin (oral) an alternative.
A virulent form of the disease, unresponsive to treatment, with WBC >50,000/μL and serum lactate above 5mg/dL, requires emergency colectomy.

Hope I have answered your query. Let me know if I can assist you further.

Regards,      
Dr. Narender Kumar
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How Can C. Difficile Infection Be Treated?

Hello and Welcome to ‘Ask A Doctor’ service. I have reviewed your query and here is my advice. Pseudomembranous enterocolitis is caused by an overgrowth of Clostridium difficile in patients who have been on antibiotics. Any antibiotic can do it. Clindamycin was the first one described, and, currently, Cephalosporins. The most common cause is profuse watery diarrhea, crampy abdominal pain, fever, and leukocytosis. Diagnosis is best made by identifying the toxin in the stool. Stool cultures take too long, and the pseudomembranes are not always seen on endoscopy. The culpable antibiotic should be discontinued, and no antidiarrheals should be used. Metronidazole is the treatment of choice (oral or IV), with vancomycin (oral) an alternative. A virulent form of the disease, unresponsive to treatment, with WBC 50,000/μL and serum lactate above 5mg/dL, requires emergency colectomy. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Narender Kumar