Vancomycin: 14 days or 21 days?

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Green65
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Vancomycin: 14 days or 21 days?

Postby Green65 » Thu Jun 01, 2017 10:48 pm

Hello.

I am completing my second week of vancomycin. One GI doctor told me to take another week of full dose vancomycin 125 four times a day before I start the taper/pulse protocol. However, another doctor told me to begin the taper/pulse after 14 days of vancomycin.

Anyone have any ideas if 14 days full dose vancomycin is less effective than 21 days? I want to be DONE with c diff! However, I'd prefer not to have to take a full extra week of vancomycin if its not necessary. Thanks for your input!

georgina
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Re: Vancomycin: 14 days or 21 days?

Postby georgina » Fri Jun 02, 2017 12:58 am

I would extend my full dose of vanco to 21 days only if symptoms persist , if symptoms are controlled and would begin to taper. I would not want to overtreat. The classic taper protocol says to begin tapering after 2 weeks of 125 mgx4 times/ day.

beth22
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Re: Vancomycin: 14 days or 21 days?

Postby beth22 » Fri Jun 02, 2017 2:25 am

I agree with Georgina. If your symptoms are under control, I would start the taper. I over treated and paid the price.

Green65
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Re: Vancomycin: 14 days or 21 days?

Postby Green65 » Fri Jun 02, 2017 8:38 am

Well.... I just had my first solid stool two days ago. Prior to that, it was not solid, but was not liquid D either. Does that mean my symptoms have been under control? I'm just not sure what the best thing to do is given that Ive only had two days of formed stools.

georgina
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Re: Vancomycin: 14 days or 21 days?

Postby georgina » Sat Jun 03, 2017 2:52 am

If you are not having high frequency , D , fever or abdominal pain that means that symptoms are under control.

Green65
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Re: Vancomycin: 14 days or 21 days?

Postby Green65 » Sun Jun 04, 2017 11:05 pm

So does having symptoms under control mean c diff is gone?

beth22
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Re: Vancomycin: 14 days or 21 days?

Postby beth22 » Mon Jun 05, 2017 1:36 am

No, it doesn't mean that. It means that if you stop the medication too early, symptoms will most likely come back. A taper gives your body a chance to adjust to being without medication and as you lower the dose of the meds, hopefully, your own flora will come back.

georgina
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Re: Vancomycin: 14 days or 21 days?

Postby georgina » Tue Jun 06, 2017 12:04 am

Cdiff will never be gone once you get infected with it , the only thing that the meds will destroy is the active Cdiff colony but nothing will kill spores. Spores will remain dormant inside your but , hiding, waiting for a chance to be regerminate.

maxny1
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Re: Vancomycin: 14 days or 21 days?

Postby maxny1 » Sat Jun 17, 2017 12:19 am

For my second recurrence, I wound up on 21 days of 125mg 4x/day (followed by 8 weeks of tapered pulse dosage), but this may have been a miscommunication among my doctors. My case was severe enough, though, that I wasn't about to quibble about whether they meant to prescribe 14 days QID *following* the 7 days QID inpatient, or including the 7 days inpatient.

kanak
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Re: Vancomycin: 14 days or 21 days?

Postby kanak » Sat Sep 16, 2017 8:38 pm

beth22 wrote:
> I agree with Georgina. If your symptoms are under control, I would start
> the taper. I over treated and paid the price.


Beth what did you mean by paid the price? Can you tell me what your experience was?

I think I may be overtreating. The did 250 4 times a day, then 125 4 x a day and so on but I ended up back in the hospital and they pUT me back on the 250 again when I was 3 weeks into the taper. When I was discharged one doctor said do 2 weeks of 250 4 x day and other nurse said I'd finish taper. We called and can't get in until next week so basically I started the taper over. I've been extremely sck to my stomach and have had a lot of abdominal pain which I've never had any of the times I've had c diff.

Amy

NanciT
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Re: Vancomycin: 14 days or 21 days?

Postby NanciT » Sat Sep 16, 2017 9:50 pm

Kanak

This thread is old, start a new one for responses.

You need to call the physician who needs to give you clear directions for the Vanco. The nurse does not prescribe, the MD does and it must be made clear. Although it's the weekend, someone will be on call.
If the nausea is severe they can give you medication for that.
I found using Sea Bands helped along with using a heating pad. Its really important to get the correct dose from the doctor

Hope you feel better soon

NanciT


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