Using antibiotics before FMT

If you have had or are considering an FMT please share your experiences here.
CSHF
New User
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Joined: Wed Oct 26, 2016 2:40 pm

Using antibiotics before FMT

Postby CSHF » Wed Oct 26, 2016 2:59 pm

Hello. I am a 46 year old female and new poster. Thanks for being here, reading my post.

I am scheduled to have an FMT via colonoscopy after a year of unsuccessful antibiotic treatment for a c-diff infection. My doctor is requiring sedation for the colonoscopy and my choice for venous access is a central line or a port. A PICC through my arm and regular IV are not possible. The port procedure requires that a dose of antibiotic be given prophylactically. I am very concerned that the antibiotic will worsen c-diff right before the FMT, possibly rendering it less effective. Does anyone have experience with this or an informed opinion about taking an antibiotic (other than the ones that target c-diff) in advance of an FMT?

Thank you.

roy
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Joined: Sat Aug 02, 2014 1:05 am

Re: Using antibiotics before FMT

Postby roy » Wed Oct 26, 2016 5:32 pm

An antibiotic given prophylactically will kill off the FMT bacteria.
It depends on what they want to use though.
IV vanco has worked for many posters as a prophylactic without causing c.diff.
Have you considered having the FMT via nasogastric, pills or enema route?
Georgina and another recent poster will confirm that the colonoscopy can be done without IV sedation, it's unpleasant and stressful but possible, and pill sedation will help.
Are you having an FMT because of ongoing D or because of test results?

CSHF
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Posts: 16
Joined: Wed Oct 26, 2016 2:40 pm

Re: Using antibiotics before FMT

Postby CSHF » Wed Oct 26, 2016 7:01 pm

Thanks, Roy. I was told that if I were to take antibiotics, I should do so two days prior to procedure/FMT so as to not interefere with the new bacteria being introduced. I'm having symptoms + positive testing for toxins. I do okay on vanco, but every time I have come off of it, including after a longer-term wean, my symptoms return AND I test positive. I have had a few tests while on vanco and have tested negative. For me, symptoms and a positive test seem to go together. This has been going on for close to a year. My understanding is that having the c-diff under control as much as possible will maximize the effectiveness of the FMT, but I'm not sure if there is research to confirm this. If this is true, then taking an antibiotic other than Vanco (or Dificid or Flagyl) would seem to be counter-indicated, even if I am having an FMT soon afterward, as I believe such an antibiotic (i.e., one other than those mentioned) is likely to worsen the c-diff. I thought about advocating for a colonoscopy without sedation, but in the unlikely event that something went wrong and the docs needed venous access, they would not be able to achieve this quickly for me. Infection is my biggest fear right now, as I'm sure others can appreciate.

roy
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Re: Using antibiotics before FMT

Postby roy » Thu Oct 27, 2016 5:07 am

Normally you would take a course of oral Vanco before the FMT to reduce the c.diff load and stop 2 days before the procedure.
I am probably talking rubbish but I am wondering if they would consider IV vanco or possibly flagyl for the prophylactic.
personally if I had your other problems I would be seeking FMT by the upper route and the lower by enema.
Cute rate might not be quite as high but it's a low risk option

georgina
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Joined: Sat Sep 12, 2015 10:07 am

Re: Using antibiotics before FMT

Postby georgina » Thu Oct 27, 2016 9:53 am

Yeah , in Romania colonoscopy is done without sedation , only an analgezic and a Valium pill and that is it!


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