surgery/antibiotics after c-diff risk

[explorerjen]

My mom is having knee replacement surgery in Dec. and the orthopedist says she must be on an antibiotic a week prior. She is afraid the c-diff, which almost killed her, will return. Her general practicioner does not want her to go on antibiotics. She feels caught between a rock and a hard place.

Has anyone had this situation? What antibiotics would you recommend?

[HEATHER28]

explorerjen,

I have never been in this situation so I am sorry that I cant help you there. My advice to you is that your Moms GP needs to talk to the Orthopedic Surgen and explain to him/her about her history with Cdiff.

What antibiotic does he want her to take? What Antibiotic did she take for her Cdiff? If she took Flagyl or Vanco maybe she could take one of those?
I understand your Moms fear of getting Cdiff again but, she also doesnt want to take the chance or the risk of getting a infection after her surgery. I work in the surgery dept. of a hospital here in my town and I see alot of patients come back after there surgerys for Incision and Drainages because there surgery site is infected.

Like I said though I had Cdiff and I know that she is scared my heart goes out to her.

[Nancy1]

explorerjen,
Welcome to the group that no one wants to join, for you and your mom. Be sure to read All Users Read This First, Dr. Borody's article, Dr. McDonald's article (in the FAQ section under Articles by Experts), and all areas in FAQ that interest you.

Heather has given you good advice. You might also check in the FAQ section under Antibiotics, which gives lists of antibiotics that are more or less likely to cause cdiff. Then you could take that list to her orthopedist and discuss them with him/her. Good luck. Let us know how it goes.

[fire7163]

When I had my neck rebuilt in April, I had the same concerns and discussed them with my surgeon. He was more than willing to use Vanco, and I didn't have any problems. Just talk to them and inform them of your history and concerns.

Fire

[maryinflorida]

explorerjen,

I had colon surgery recently with a minimal amount of antibiotics. My surgeon was fully aware that I had recovered from cdiff just a few months before and agreed that the risk from the use of antibiotics for prophylactic reasons was greater than the risk of infection during the surgery, so he modified his routine and everything worked out fine. He put me on Flagyl during the surgery and when that made me sick as a dog (it turns out I get very strong side effects from that particular antibiotic) he switched me to an antibiotic called Tygacil, which was suggested by my ID doctor. I was on antibiotics for a total of about 2 days, was released from the hospital on the third day, and went home to recover on my own without any prescriptions. I had no problems or complications from the surgery except for my lungs not clearing fast enough after the anaesthesia. That's why he had to keep me on antibiotics for an extra day, even though the surgery itself went very well. I was 54 and with no other health problems except for the cdiff and severe diverticulitis (the reason for the surgery); your mother's age and overall health condition might required a different approach and a doctor has to make that decision, but sometimes it is a good idea to get 2nd and even 3rd opinions before something as serious as surgery. But surgery with minimal use of antibiotics is becoming more popular as many doctors become more aware of the risk antibiotics pose to patients in hospitals.

[carrie]

yes it is worth a discussion. My gyne says I need to have a hysterectomy as soon as I feel ready. He knows I'm terrified because of having cdiff from taking an antibiotic(I was not hospitalized at the time). He has agreed to do it without the antibiotics as he feels my risk for cdiff is higher than my risk of infection. This in itself makes surgery easier to come to terms with. Maybe ask her surgeon if there is someone who will consider options. I know my gyne was going to use 2 antibiotics and one of them was flagyl. He uses both antibiotics routinely for surgery to prevent a bladder infection from the cathater used during surgery and the second to prevent infection at the incision sites. He is a well known for his work in the city so I feel very fortunate to have him be so open to my concern. The first time I went to see him he said he has never had a patient get cdiff after surgery and was not really listening to my concern. The second and third time we had the conversation he completely changed his attitude and was very supportive. Now if I could only get my GI to be a little more understanding and compassionate! The last time I went to see him I took my husband to back me up as he thinks I'm this stressed out person. My husband spoke up and said "I don't know why you push my wife's buttons so easily but you really get to her, it's amazing to see what happens when shes in your office." After that he said well there is no reason for you to come into my office for follow up we can work through your physician and I will send him the treatment plan. This was also huge progress but I still didn't feel he was understanding of the issues. My physician is very supportive. Sorry for babbling, just trying to make a point that sometimes there are options. Could someone help speak on your mothers behalf? My GI didn't ever really listen to me but I think he finally believed it when my husband told him the impact he had on me.

[Bobbie]

Same old story. If a woman is concerned, she is "over reacting." If a man is concerned, it is for a good reason.

I sat next to a doc. on an airplane trip years ago. He started a conversation, told me what he did, etc. I asked if, "If two people came in your office with the same symptoms, who would you listen to first, a man or a woman?" He said the man because males rarely go to docs. except as a last resort (or at the insistince of their wives/mothers/ girlfriends/companions).

My husband & I both had "the flu" -- his diagnosis. (My symptoms could also be attributed to IBS.). He went to bed for 2 days. He is still complaining that his stomach is "rumbling." My stomach has rumbled (since my lst bout with C. diff.) for 15 yrs. without much interest.

[Jan]

I myself would be very worried about taking antibx again. I had 2 surgerys after my first C Diff experience. After each surgery I did end up with C Diff again. The first surgery the doctor used Flagyl. The second surgery, the doctor used zero antibx. So.....I am afraid to even have surgery with out antibx any more for I still ended up with the beast once again.
Jan