Probiotics with or after vancomycin

[davidm]

I have just started taking Vancomycin, and from what I have read, it is useful to take probiotics during and after the Vancomycin. The ones most recommended are S Boulardii (a yeast) and L Rhamnosus GG (to heal the gut).

I was wondering what doses people take of these two organisms during and after the Vancomycin?

One manufacturer I was speaking to did not use GG but a strain called LR-32 which they said had not been researched as much as GG, but showed similar benefits. Does anyone know anything about this?

[Lisa33]

I am not familiar with GG or LR-32. Although I googled them, and they both sound very beneficial. My GI wanted me to take 2-3 capsules of VSL-3 per day, which is Lactobacillales or lactic acid probiotic. However, the vanco will kill it, so you have to space it apart. However many on this site also take the S. Boulardii while fighting c-diff. I did not take S. Boulardii until I was in recovery. While I had c-diff, I took 2-VSL 3's per day, ate 2 yogurts per day and drank Kefir everyday. In recovery, I take 1-VSL3 and 1-Florastor per day, and still try to eat one yogurt per day and drink Kefir. The amount of probiotics to take is really an individual thing in my opinion. I think it depends on how your body reacts to them and tolerates them. There honestly are so many probiotics on the market that it is very overwhelming to me. I went by what my doctor recommended, as well as, what worked the best for posters on this site.

Lisa

[zinnia1]

Lisa- didn't the yogurts and kefir cause more diarrhea ? I am so confused about that and what is the what…

[davidm]

There have been a number of studies of S Boulardii use in conjunction with Vancomycin which showed significantly improved relapse rate. In these studies, they often used 500mg S Boulardii twice a day. The S Boulardii packets usually say one or two capsules a day, often only 250mg each.

http://cid.oxfordjournals.org/content/31/4/1012.full

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC174670/

This one, from Borody's organisation, refers to L GG as being useful:

This lactobacillus is a probiotic which was isolated by Drs Sherwood Gorbach and Barry Goldin (hence LGG) is available in many countries for treatment of chronic CD infection symptoms. On its own LGG may suppress CD. When combined or preceded with vancomycin and metronidazole it may be curative in some situations. In our experience it is probably required in high doses and for longer periods of time. The major advantage of LGG is its lack of side effects and potential for cure in some patients. (11,15,27)

http://www.cdd.com.au/pages/disease_inf ... ficle.html

[beth22]

There was also a study done (see media reports) that showed much lower relapse rate when you drank kefir when treating with vancomycin. I believe it was 5oz with each meal.

http://www.healio.com/infectious-diseas ... solved-cdi

[davidm]

Interesting. It would be much easier to drink kefir, but unfortunately I cannot tolerate dairy at all. Even ghee upsets me and that has no protein or lactose in it.

I wonder if water kefir would work the same? Probably has a different bunch of bacteria and yeasts.

[beth22]

The kefir that is sold here in most markets is supposed to be 99% lactose free. It is the Lifeway brand. Some people get the grains and make their own and I assume you can do it with soy milk, maybe almond milk or rice milk? I know there are posters who have grown their own, so maybe they will see this and answer.

[davidm]

My problem is with the milk protein casein. I have no trouble with lactose.

[seekingcure]

I make my own kefir with kefir grains, but I only use whole milk. I tried fermenting coconut milk once and I didn't care for the taste, but some people love it. I believe the grains will grow in coconut milk. However, they will not grow in soy milk, almond milk or rice milk. These milks can be fermented with the grains, but the grains will have to be "revived" in dairy milk every few uses.

Fermented foods such as sauerkraut, lacto-fermented pickles and tomatoes, etc. are good for rebuilding gut bacteria as well and are even okayed by most doctors for use immediately after FMT, although commercial probiotics are usually not recommended for awhile. I get the Bubbie's brand pickles and sauerkraut, but the tomatoes are not available near me. You could also try kombucha tea. I have not yet tried water kefir so don't know much about it.

[sevla]

For me it's so interesting that doctors don't agree onf if to take probiotics, when to take them, etc. Each doctor I talked to had a different opinion (2 of them c diff specialists). According to all - all probiotics are the same..what!?!
I am just following what I am reading here and in reports written by experts. As I was taking Vanco and Dificid I took 500mg of Florastor twice a day, Culturelle (30million once a day), Kefir. Now that I just went off Dificid I added VSL#3. I think I am overdoing it a little, but I just want to be on the "safe side" - it makes me feel better (at least emotionally) to take all of these. But as many said, it is an individual thing as some people do not tolerate well some of the probiotics. I also read great reviews about a brand called Custom Probiotics - it has even been used for lymes and h pylori.

[NanciT]

I had the same issue with the doctors not agreeing. My past GI said....once C DIff free the VSL#3 is a waste of money. Well, I changed GI's and the new one has me continue on with it. I now take 1 per day but plan on staying on it, I had difficulty with Kefir and most yogurts.

There are so many things these Dr's can't agree on when it comes to C DIff. Makes it very hard for the patient!!

Hope you feel better really soon!!

[Bobbie]

Seldom do two doc's - even in the same field - agree on anything. And many are adamant his/her methods are best - making it difficult on us patients. BUT if you have a GUT feeling about something, it trumps all medical knowledge. Trust yourself.