Start probiotics BEFORE prostate biopsy to prevent C. diff?

[concerned lady]

Need advice for my husband:

He will be going in for a prostate biopsy in mid to late October, in Denver. He must take some antibiotic --not sure which one yet (?1 day before the biopsy, and 2 days after it).

His immune system has always been a little sub-par (due to previously unrecognized gluten sensitivity, plus life stresses, and work related toxins, etc.), so I'm very concerned that he may get C. diff (I have it now) from the antibiotic he's going to have to take soon.

How many days BEFORE the first antibiotic dose, do you all think it might be wise to have him consider starting to take Florastor and Acidophilus probiotics, as a preventative measure? (&/or any other probiotics others have tried and liked)

From reading others' posts here, I think my hubby should continue on the probiotics, for at least a month AFTER he has to take the antibiotics that are in connection with his prostate biopsy.

How many days, IN ADVANCE, of the first antibiotic, would be a wise time to start the probiotics?

Would love to ask local docs about this, but here in Colorado, most just roll their eyes when the word probiotics is mentioned, and are not near as knowledgable about C. diff. as everyone on this wonderful site is!

In fact, the nurse of the urologist my hubby will see, is interested in learning about C. diff. I will give her a link to THIS SITE!

Please share your thoughts, so I can try to help my hubby prevent getting C. diff! I'm now thinking that maybe there was a reason why I got it--to help him NOT get it.

Carol/Concerned lady
fsds@rkymtnhi.com

[Allison]

Hi,

There is no standard protocol for when to begin probiotics when taking antimicrobials prophylactically. Instructions from most of the manufacturers just list "in conjunction with antibiotics", in their directions for use.

A good source for these kinds of recommendations may be the manufacturers themselves, and/or a knowledgeable pharmacist.

FYI: The reaction from some docs about probiotics doesn't necessarily mean they are not cdiff knowledgeable, but that they would like to see evidence based results before making recommendations for treatment, and to date, there aren't any.
There is, however, a build-up of anecdotes that implies probiotics may be more effective in preventing cdiff, rather than "cure", so always a good idea, me thinks.

[concerned lady]

Hi Allison,

Thank you for your reply! Great advice. I'll contact the manufacturers (Biocodex, that makes Florastor, and Jarrow that makes a non-freeze dried type of Saccharomyces boulardii friendly yeast), and I'll contact a pharmacist (like maybe Martin, in NYC, who works for Biocodex).

Also, if anyone reading this has some personal (anecdotal) experience with having prevented C. diff. by taking probiotics, IN ADVANCE of having had to take any kind of antibiotics, I'm all ears! Let me know!

Carol/Concerned lady
fsds@rkymtnhi.com
970-531-5000

[concerned lady]

Hi Allison, and all!

I just found out that the antibiotic my husband will take, in connection with his upcoming prostate biopsies, is called Septra DS (DS means double strength), and this is a Sulfonamide type antibiotic.

I looked up adverse effects, and, as many of you knew, and I just found out, C. diff. is a distinct possibility with this antibiotic.

I also was not happy about the BIG BOX of serious WARNINGS & PRECAUTIONS, that said rare but fatal adverse effects can happen, from Sulfonamides! (looked worse than the warnings about Keflex!). This info came from RxList.com, a pharmacist's website.

My hubby had a serum sickness like reaction to penicillin once (with shoulder girdle involvement), so that's not an option (and is too narrow spectrum for prostate biopsies).

He almost ruptured his Achilles tendon from previously taking Cipro (a fluoroquinolone), so that's not an option. He wasn't the only one with this side effect. One of his own previous doctors did rupture his Achilles tendon, from having taken Cipro!

He didn't do well, in the past, when on Ceftin, which Rxlist says is a "semisynthetic, broad-spectrum cephalosporin..."

So his options may be limited.

Does anyone know of any less dangerous antibiotics, that could prevent infections that are possible from prostate biopsies (I think they're going to take about a dozen samples during the biopsy! and the nurse said the doc will be "pushing poop into sterile places where it normally wouldn't be"), yet wouldn't have so many potentially fatal side effects (not even counting C. diff!)?
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Also, I heard back from the wonderful medical people: Dr. Aas and Lynne McFarland (by email), and, I also called up Martin (pharmacist) in New York City.

Here's what they each recommended, regarding timing of PROPHYLACTIC (in advance of antibiotics) use of the Florastor (friendly yeast--Saccharomyces boulardii), to try to PREVENT C. diff. from even getting started!

Both Lynne and Martin recommended starting the Florastor 3 days before the first dose of the "needed" antibiotic, because they said it takes 3 days for the yeast to reach a "steady state".

Dr. Aas said to start it at the same time, as the first dose of the antibiotic.

So, I'm going to err on the side of caution, and start my hubby on Florastor 3 days in advance of his first antibiotic dose.

Then, Lynne & Martin recommended keeping my hubby on the Florastor for a week after he stopped the antibiotics.

But, Dr. Aas recommended keeping my hubby on the Florastor for 10 to 14 days after his last antibiotic dose.

Again, I'm going to err on the side of caution, and keep him on the Florastor for at least 14 days after his last antibiotic dose.
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Has anyone here used Florastor (Saccharomyces boulardii) BEFORE needing to take an antibiotic? If yes, what were your experiences? Did it prevent C. diff?
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I also emailed a link to this wonderful website, and included some introductory info about C. diff., to one of the nurses of the urologist who will be doing the prostate biopsy on my hubby, later this month.

When I spoke with another one of the urologist's nurses, today, I asked her if any of the biopsy patients ever got C. diff. from the antibiotics, and she said...yes. But, they don't do any prevention, I believe.

Thanks, in advance, to all!

Carol/Concerned lady
fsds@rkymtnhi.com

[nsewell]

Hi I have had to take meds since having the c-diff. The ones I have been on are azythromicyn, zithromax and a sulfur one. I eat activia eveyday on them and also upt my probiotics to 2/day. I take one that has acidiphyllus and bifidus in it. I was lucky and didnt get it again. I dont think theres any guarentees but it wouldnt hurt to start probiotics a couple weeks before. My GI doc said they are now recommending the activia yogurt to paitents that have had bowel surgery because it is real good for you. Good luck.

[Jayne]

Carol...good for you (& hubby) that you are being proactive. Sounds like the research you have done is helpful. It makes sense to "air on the side of caution" regarding durations of intake before & after. I would definately consult with all of hubby's drs & a pharmacist familiar w/your husbands prior usues w/reactions from antibiotics & deduce which one will work the best w/the least possible risks. The suggestion to also take DanActive/Activia type yogurt also sounds helpful.

My 1st case of CDiff was severe & my family was definately exposed, however my 13yr old son had to take antibiotics for toe infection & I had him on Florastor & DanActive during the entire course (10 days) & he faired very well. It really has a lot to do w/each individuals body-but it sounds like you're doing the best you can to prevent hubby from getting affected by CDiff. Hope it goes smoothly. Let us know.

[concerned lady]

Hi nsewell!

Thank you for your reply! I'm glad that taking twice your regular amount of probiotics, seems to have helped prevent you from getting C. diff again, from antibiotics.

I've already started my hubby on Acidophilus & Bifidus (milk-free), and he is agreeable to starting on the Florastor (Saccharomyces boulardii friendly yeast probiotic), 3 days before he starts taking the Septra DS antibiotic.

When he starts the antibiotic, he'll take the Acidophilus/Bifidus several hours away from each antibiotic dose, so both the antibiotic and the bacterial probiotics, can be effective, and not cancel eachother out!

I would give him the yogurt, but he may be either allergic to, or sensitive to milk proteins, making him more congested (phlegm, stuffy nose, diarrhea, etc.), so it'll probably be milk-free probiotic capsules. He could try the soy yogurt, (like BioK, etc.), if he wants to try that.

Thanks again for sharing what helped you!

Carol/Concerned lady
fsds@rkymtnhi.com

[concerned lady]

Hi Jayne!

Thank you for your support, and for sharing what helped your son to not get C. diff! (taking Florastor plus DanActive, while he was on antibiotics for 10 days). We're definitely going to err on the side of caution!

My hubby will follow your good advice, and will speak with his GP/general practitioner, and with the Urologist, to see if there might be a less dangerous antibiotic that could work for him to take, for the biopsy! We both don't want him to get any liver or kidney problems, or worse!

Unfortunately, in our semi-rural area, all previous pharmacists sold their drug stores, when big supermarkets moved into the area, and started their own internal pharmacies, so there's no pharmacist to consult who used to know my hubby's history of drug reactions!

The Urologist said OK to my hubby taking Florastor before, during & after taking the antibiotic! I also emailed info about this great website, etc., to one of the Urologist's nurses, who was interested in learning more about C. diff!

I hope they'll think about some ways to try to prevent C. diff., for their future patients...

I also spoke with a lab lady at my local clinic, and she was interested in C. diff., but didn't know about it. I'll email her info, including about this website!

Thanks again!

Carol/Concerned lady
fsds@rkymtnhi.com