Flagyl

[AndyShax]

Flagyl (metronidazole) has been first choice treatment for Cdiff for decades.

It is the most toxic of the treatment options and can cause dizziness, headache, diarrhea, nausea, stomach pain, loss of appetite, constipation, peripheral neuropathy, changes in taste, and dry mouth. More rare side effects include eye pain, severe/persistent headache, sudden vision changes, stiff/painful neck, sore throat, persistent fever, unusual bleeding/bruising, severe stomach pain, persistent nausea/vomiting.

It used to be very effective with a 90%+ cure rate when first introduced to the market.

Time passed, the bacterial strains evolved and Flagyl lost its efficiency but retained its toxicity.
A review was published by Journal of Clinical Infectious Disease studying just how effective it is these days:

http://cid.oxfordjournals.org/content/40/11/1586.short

Study Sample: 207 patients treated with Flagyl for Cdiff infection.
Results:
- 50% of patients responded to treatment
- 22% of patients received no benefit
- 28% received some benefit but relapsed after the treatment ended

The study was completed 10 years ago. Results are likely even worse today.
WIth these poor results, Flagyl would fail FDA clinical trials if it was coming to market today.
However it still remains #1 treatment option. If you go to a primary care physician with a cdiff problem, you'll be getting a pack of Flagyl.

Combination treatment with oral vancomycin followed by fecal transplantation has a 95%+ cure rate.
I realise most people will read this AFTER they already took a flagyl course. If you havent yet done so, make an informed choice.

[beth22]

You forgot peripheral neuropathy. My mother got it after treating her c diff with Flagyl and she can't use her hands to this day. They were painful and she kept them closed and then developed strictures I believe they are called, and now can't open them. Other posters have had peripheral neuropathy as well.

[AndyShax]

Added peripheral neuropathy to the list of side effects!

[AllisS]

Re: statement "It is the most toxic of the treatment options, causing dizziness, headache, diarrhea, nausea, stomach pain, loss of appetite, constipation, peripheral neuropathy, changes in taste, and dry mouth," I believe this should be restated as "CAN cause," as those are POTENTIAL side effects, which are listed for ALL drugs. I didn't find Flagyl effective either and am not making a case for its use, but ineffectiveness is different than a likelihood of contracting certain side effects.

I'm not a medical practitioner, either, but I worked as an editor on medical journals for many years, and precision in language usage is important, especially when the readership is primarily nonmedical folks.

[AndyShax]

Updated... I was going to put percentages of patients who experienced the side effects, but some work came along and I had to finish early.

[Kathy George]

Andy, I'm sure we can google research results on our own. At times, to much data can become confusing and unnecessary. Some individuals can become disillusioned by overdosing on excessive information received via internet.
Kathy

[AndyShax]

Just posting the facts, Roy.. this is not a "dont take flagyl" page, its a "Flagyl" page with the latest figures on how efficient it is. Treatment choice is ultimately with the patient and their physician.

Point well taken on MRSA and resistance development, I already met a patient who had vancomycin-resistant Cdiff. Vancomycin-resistant MRSA has been reported in multiple places. Anger at vancomycin abuse is best directed at physicians prescribing "36 week" and "forever" antibiotic courses.

Ultimately all antibiotics lose efficiency as bacteria evolves, Vanco and Dificid will follow the path of Flagyl in due time.

For the insurance company, the choice is a no-brainer - flagyl is $10 a full course, vanco is $1000+, dificid $3000+, FT done professionally $3000+
Thats the reason flagyl is given first, medical considerations are distant second.

[Bobbie]

Andy, I think you should "have the picture." by now as we moderators have been concerned for quite some time you are offering too much medical advice. This is not a medical site - it is a support site. Warnings about meds. are appropriate, but remember although the typical person who visits this site is more sophisticated now then he/she used to be, let's not scare the hell out of them after we offer support. I've been on Vanco. often during my 20 years of C. diff. (both on IV & oral - on it for four months now) & I know the risks and accept them; others might "whig out."Just the fasts, Ma'm" (from an old TV detective show) is fine - with some preparation first.

Perhaps your lengthy experience with the "at-home enemas" could be a blog as it is in diary/blog format/or perhaps listed in "Case Histories." We value your information - just "tone it down" a little please. Thanks for stopping "repeating questions" and for adding medical disclaimer. I didn't see at first; you might enlarge font.

They key to an effective support site is empathy plus education -- understandable by the general population.

[Kathy George]

Andy, Roy and Bobbie are professionals and they are politely trying to tell you to back off a little....... Your posts are long winded!!! Knowledge can be a burden especially for one who thinks they know everything. Most people don’t realize it, but if you look at most people that are in a genius category, they drive themselves nuts because they go into overdrive thinking about particulars/specifics way too much!!! I know you mean well, but more often than not “Less is More”.
Kathy