Unanswered Questions

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jnet1229
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Unanswered Questions

Postby jnet1229 » Thu Aug 02, 2018 10:42 am

Hi All,
I am approximately 2 weeks into my diagnosis of Cdiff. Like many of you my world has been turned upside down. I have turned to many websites for information and feel myself even more confused than when it started. My Cdff is a result of Clindamycin for a wisdom tooth. Ironically I was given a 10 day supply of it but quit taking it after 4-5 days because it upset my stomach. However whats weird is the C diff didn't start till 1 month after I quit the meds. I started with symptoms on a Wednesday and by Saturday I had my diagnosis and prescription. My questions is, my doctor prescribed me 21 days of 250mg (3x a day) metronidazole. Everywhere I have read I never seen this prescribed for that long. Has anyone else had this? Also he is recommended a colonoscopy after I "hopefully" beat this. I have read different opinions on if this is necessary. Is the colonoscopy because he fears there may be more going on?
I am so scared that I will never be normal again. Please any insight is appreciated!

roy
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Re: Unanswered Questions

Postby roy » Thu Aug 02, 2018 10:52 am

That's totally the wrong prescription!
Ask your Dr to check the latest treatment guidlines.
Metro is no longer used and Vanco is the standard treatment (better still dificid).

roy
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Re: Unanswered Questions

Postby roy » Thu Aug 02, 2018 10:53 am

A "simple" c.diff infection does not require a colonoscopy.

jnet1229
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Re: Unanswered Questions

Postby jnet1229 » Thu Aug 02, 2018 10:54 am

Do you know if anyone has ever switched in the middle of a prescription?

roy
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Re: Unanswered Questions

Postby roy » Thu Aug 02, 2018 10:55 am

Yes, a lot of people switch.
Follow this link, print off and show your Dr.

viewtopic.php?f=6&t=20521

jnet1229
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Re: Unanswered Questions

Postby jnet1229 » Thu Aug 02, 2018 11:05 am

So is the Metro bad for me?

Amanda
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Re: Unanswered Questions

Postby Amanda » Thu Aug 02, 2018 11:13 am

Lots of doctors and hospitals use metro (Flagyl) as the first line of response to c diff. The stansard treatment is 10 days, 500mg 3x per day. That being said, Vancomycin and Dificid are better drugs for this infection.
I’m trying to change GI because my doctor, who is very known and respected in the field, appears to want to stick with Flagyl even after recurrence. Either he is not updated or he does not want to change for whatever reason.

roy
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Re: Unanswered Questions

Postby roy » Thu Aug 02, 2018 11:23 am

Its cheap so they try it first but have now been instructed to use it only if Vanco or Dificid is not available.
It has a much higher relapse rate than the other meds.
It damages the good gut flora.
It can have nasty side effects.
It has been known to CAUSE c.diff.
It's never been FDA approved for c.diff.
All that said it might still work, but your not on the correct dosage.

From the new guidlines

Either vancomycin or fidaxomicin is recommended over metronidazole for an initial episode of CDI. The dosage is vancomycin 125 mg orally 4 times per day or fidaxomicin 200 mg twice daily for 10 days (strong recommendation, high quality of evidence) (Table 1).

In settings where access to vancomycin or fidaxomicin is limited, we suggest using metronidazole for an initial episode of nonsevere CDI only (weak recommendation, high quality of evidence). The suggested dosage is metronidazole 500 mg orally 3 times per day for 10 days. Avoid repeated or prolonged courses due to risk of cumulative and potentially irreversible neurotoxicity (strong recommendation, moderate quality of evidence). (See Treatment section for definition of CDI severity

jnet1229
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Re: Unanswered Questions

Postby jnet1229 » Thu Aug 02, 2018 11:26 am

That's what worries me. Most people take a stronger dose for 10days only and I am taking 250mg 3x a day for 21 days. Not sure why this is?

georgina
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Re: Unanswered Questions

Postby georgina » Thu Aug 02, 2018 12:54 pm

My personal opinion is that you should start looking for a more knowledgeable doctor!

roy
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Re: Unanswered Questions

Postby roy » Thu Aug 02, 2018 1:55 pm

Its because your Dr is wrong and prescribed the incorrect dose.
Get a second opinion if you dont want to challenge your Dr.
I would compare it to feeding a rat only half a dose of poison.
The rat survives and becomes stronger.

MKW
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Re: Unanswered Questions

Postby MKW » Thu Aug 02, 2018 7:52 pm

I have to agree with other posters that you should get a second opinion. Unfortunately, with c diff, it's hard to find a knowledgable doctor. I trusted my first doctor, and in the end as I learned about c diff, I discovered he had no idea what he was doing or talking about. Very inexperienced. But doctors act arrogant and decisive, but really... that doesn't mean anything. And i suffered for it and ended up in a relapse cycle. In retrospect after I learned more, I feel that if I had received different dosing and treatments, I may not have ended up requiring an FMT. Get a second opinion now. I say with c diff hope for the best, but prepare for the worst. The Infectious Disease Society of America current treatment guidelines recommend Vanco and Dificid ONLY.

Ril
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Re: Unanswered Questions

Postby Ril » Thu Aug 02, 2018 9:57 pm

Most drs, especially GIs, are good and knowledgeable. If your dr won’t change your meds even after discussion and/or showing Roy’s link, be prepared with an appointment with another GI for a second opinion.

roy
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Re: Unanswered Questions

Postby roy » Fri Aug 03, 2018 4:46 am


jnet1229
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Re: Unanswered Questions

Postby jnet1229 » Fri Aug 03, 2018 2:39 pm

Ok, so I spoke to the doctor and he said he has seen greater results in re occurrence with hitting it slow and steady. However he said he is fine if I want to bump it up to 500mg 3 x instead. I hope this works.


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