Is Vanco taper more effective than two weeks straight vancomycin?

Treatments, possible treatments, unsubstantiated/unproven treatments. Consult your doctor first.
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Is Vanco taper more effective than two weeks straight vancomycin?

Postby Green65 » Fri May 19, 2017 10:01 pm

My GI doctor put me on two weeks of Vancomycin. However, most of what I've read on this site is people being put on a vancomycin taper. Did anyone get better with first round of vancomycin for two weeks? Thanks!

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Re: Is Vanco taper more effective than two weeks straight vancomycin?

Postby midway » Fri May 19, 2017 10:22 pm

If you ask around, you'll get a lot of different answers. Vancomycin is more effective than Flagyl, so there are some who have success with a single round of vancomycin for 14 days. Some doctors prescribe a taper following the 2 weeks, but I'm not sure if there's much evidence in the medical research community that shows if it's better.

The state of each person's gut flora is different, which is why some treatments work for some, but not others. I visited with an Infectious Diseases Doctor, and he described that your body needs sufficient time to reestablish good flora in your gut. Flagyl kills off C diff bacteria, but it also kills off a lot of your good bacteria. Vancomycin kills less good bacteria, so your gut can start to recover while on the antibiotics. Do what you can to introduce bacteria into your system. Not just the probiotics that people frequently discuss here (yogurt, miso soup, pills, etc.), but every day bacteria! As goofy as it sounds, the ID Doctor told me to go shake more hands. Anything short of licking the floor of a train station.

I digress. Do what you can to introduce bacteria while on your 14 days of vancomycin, and you might consider asking him/her whether a taper would be recommended for you.

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Re: Is Vanco taper more effective than two weeks straight vancomycin?

Postby Lisa33 » Tue May 23, 2017 9:19 am

I relapsed two weeks after Flagyl. Was put back on Flagyl, but was horribly ill and couldn't tolerate the Flagyl any longer. After 9 days of Flagyl hell, was switched to 14 days of vanco. The 14 days of vanco cured me. So, yes I am an example that a single round of vanco can work. However, given your other post that you are tackling tick-borne bacteria as well, you should discuss the best treatment plan with an ID doctor. I would want to know if a taper is better for your situation, or even Dificid or Dificid taper as an option, given that you need all the good gut bacteria in tact if you need to take another antibiotic for the other infections. You really should discuss the best treatment plan for you with an ID doctor.

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Re: Is Vanco taper more effective than two weeks straight vancomycin?

Postby DrMike » Sat Jul 15, 2017 9:03 pm

One method that gets used a lot is the "pulse" regimen. The idea is that C. diff forms spores and those spores are not sensitive to vancomycin (or any antibiotic) because they're barely even alive. Vancomycin works on the living bacteria.

So you do a pulse of vancomycin. That gets rid of the living bugs. Then you stop and the spores come out of hiding and live and then you hit them with Vanco again. And the theory is that after several rounds of this you should be rid of the spores.

Except usually it doesn't work because you have to get rid of EVERY LAST SPORE and that's not realistic. By contrast, with FMT a new complex community of bacteria compete out any living C. diff. The spores, if they try to sporulate, get the same brutalizing by the community. Eventually, fecal passage and stuff pushes out the last of the spores. There may also be some organisms in healthy flora that eat C. diff spores, but that's uncomfirmed. But of course, FMT is kind of a tall order.

Good luck!

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