1st and 2nd round of infection

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jennnny
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Joined: Sun Dec 17, 2017 12:13 pm

1st and 2nd round of infection

Postby jennnny » Fri Jan 05, 2018 11:42 am

Hello all,

I had taken clindamycin for a tooth infection and developed cdiff slowly over 2 weeks. It started off with a lot of m which I have had happen in the past then D once per day but my husband said his stomach bothered him too, then lots of pain m and b and some normal stools and D. I was tested for a number of infections via stool test and was started on vanco 125mg 4x a day for 14 days for my positive cdiff result on 12/14. I also took florastor 2x per day and culturelle. I improved on the vanco but it took awhile to get solid stools.

I stopped the vanco, had lots of pain and gas with slightly smelly solid stools and relapsed very quickly in 6 days. At the first watery D, I thought maybe it was PI IBS but I went about 30 times with lots of b, m, pain and a fever that went to 102. I called and was given vancomycin same dosage for 10 days and was told if I relapse a third time they will consider other options.

I did email my GI because I was seeing a PCP for this issue prior since he is hard to reach. I was thinking that because I relapsed so quickly and badly, perhaps I should be on a longer course or try a pulse/taper? Also, I am on a PPI drug aciphex which I know is only going to make things worse, I have other medical conditions and off of the PPI drug my gastritis was so bad I would be on a liquid diet for months at a time and lost tons of weight. I had tried other heartburn remedies to no avail. Thank you for reading all of this and this site has been so useful these last few weeks.

Best,
Jenn

NanciT
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Joined: Thu Sep 18, 2014 12:01 pm

Re: 1st and 2nd round of infection

Postby NanciT » Fri Jan 05, 2018 11:56 am

Hello Jennny and Welcome to the site Please read the first thread for all new posters

Sorry you had to find us. I would make sure and see your GI. If you have relapsed on Vanco they often will go to a Vanco taper which is longer but I would discuss Dificid with your GI. Ask about a Dificid taper, so many including myself have done really well and finally beat this on Dificid. Often it becomes an issues of cost and your insurance but I would talk with the GI about it.

As far as the aciphex, I was also on this the entire time I was treated for CDIFF( 1 year). I had 3 different GI's tell me that I had been on it so long(several years) they were not concerned. I WAS able to get rid of CDIFF while on it. It's been 2 years and about 6 months ago I tapered off the aciphex and moved on to Pepcid ac but it has been a slow process, also had an endoscopy to confirm all was ok.

Try and get in with the GI,hope you fell better soon!

NanciT

jennnny
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Posts: 8
Joined: Sun Dec 17, 2017 12:13 pm

Re: 1st and 2nd round of infection

Postby jennnny » Sun Jan 07, 2018 2:15 pm

Thank you so much, NanciT. I emailed my GI office back and forth a bit, they said to try to stop the PPI if I can tolerate it. I do not think I will be able to since my reflux is so bad on the aciphex I am almost throwing up my precious vancomycin pills. I did read a bunch of journal articles and didn't see significant differences in treatment outcomes (for tapers and/or FMT) depending on PPI usage so that is promising. I have been off PPIs many times in the past and it always end up in gastritis and damage.

The GI office said to stop culturelle during the vancomycin because of competing bacterial load issues? I have never heard of that but I am fine with just taking florastor for now. I am trying to get an appointment with them before this round of vanco is up (which seems unlikely - it usually takes months even when I am unable to eat solid food). If not, I will try to see my PCP this week about it. Take care :)

NanciT
Long Time Contributor
Posts: 3035
Joined: Thu Sep 18, 2014 12:01 pm

Re: 1st and 2nd round of infection

Postby NanciT » Sun Jan 07, 2018 3:22 pm

I would not just "stop" aciphex, there is a taper process. I actually had 3 GI's tell me during my year of CDIFF they did not feel it attributed to my relapses, they all felt I had a very difficult strain because of my 25+ years in direct patient care. If you did attempt, I went online and my new GI and I agreed I would taper down slowly and supplement with Pepcid AC which is what I did. It's been nearly a year, and not easy. I tried apple cider vinegar on bad days which did help a little also had an endoscopy to make sure nothing else was found before going through this process.
I have been off aciphex for about 3 months, have to increase Pepcid on some days even when eating something very bland. It takes time but I am happy I did it.
Right now I would focus on getting through CDIFF. I did a pulse/taper of Dificid and finally got rid of it....while still on the aciphex. wishing you the best!

NanciT

jennnny
New User
Posts: 8
Joined: Sun Dec 17, 2017 12:13 pm

Re: 1st and 2nd round of infection

Postby jennnny » Sun Jan 07, 2018 3:39 pm

Thanks again! I agree with you, I would not try to stop the aciphex right now especially since I am in such a state. I did ask them if they had a lower aciphex dosage I could step down to in the future but I did not get a response to that. In the past, I slowly tapered off of nexium and did okay because amitriptyline was controlling my reflux at the time (which was news to me when I went off it a year later). I am glad it is working out for you without the PPI! I did not have any luck on Pepcid, Zantac, Carafate, with ACV or elevating my bed but I have other medical conditions that contribute (dysautonomia, rapid gastric emptying, hiatal hernia and so forth). I also don't trust my GI's advice that much because it has been not great at times in the past but where I live there are not many GI options. I will be doing a lot of research myself today before I have my next appointment and I am also looking into testing my spouse's stool incase I end up doing a diy FMT (if a vanco taper or dificid doesn't do the trick).

shooten
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Joined: Mon Aug 14, 2017 6:00 pm

Re: 1st and 2nd round of infection

Postby shooten » Wed Jan 10, 2018 5:51 pm

I have also had severe gastritis in the past and am currently recovering from C Diff. I was on 40mg of omeprazole for about 6 months to help cure my gastritis. My GI told me I could stop the omeprazole cold turkey. Boy was he wrong. I had the worst acid rebound. I ended up dropping my dose to 20mg once a day for 2 weeks, then one 20mg every other day for 2 weeks, then if I tolerated that I stopped the omeprazole and started taking 300mg ranitidine for 2 weeks and then was able to take the ranitidine as needed after that. Some people will drop from 300mg ranitidine to 150mg ranitidine if they can't stop after the 300mg ranitidine. There is a journal article titled "Impact of Clinical Pharmacists’ Recommendations on a Proton
Pump Inhibitor Taper Protocol in an Ambulatory Care Practice" that has a breakdown of the protocol I followed to get off my PPI.

Also, don't take vanco on an empty stomach. I found out the hard way that when you take it on an empty stomach it does not react well with stomach acid and causes you to have symptoms very similar to gastritis.


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