Atypical Vanco Taper/pulse

[Anib]

Hi, I’m a 39 year old female and was diagnosed with c. Diff on 4/21 after taking multiple rounds of antibiotics for a stubborn h. Pylori infection. I realized immediately that I had c. Diff and went to the ER, got diagnosed and started on a 10 day course of vancomycin 12 hours after symptoms began. Unfortunately, 9 days after finishing the med, I relapsed. I called my GI and was started on vanco taper/pulse, which I am taking now. My question has to do with this regimen he prescribed. He wanted me to take vanco 125 mg QID x 2 weeks, then bid x 1 week, then 1 every 3rd day x 4 weeks. After reading this forum and multiple research articles, I realized that this is a very unconventional taper/pulse regimen and decided that I would try tapering to bid after 10 days and not 14 (which I’m doing now) then Qd x 1 week, then 1 every other day x 2 weeks, then 1 every 3rd day x 4 weeks. I’ve done the math and will have the exact right amount of meds for my regimen. My question is has anyone had success with my GI’s taper/pulse regimen? Am I missing something? Is there new research that says it’s more successful than the more conventional methods? Which regimen has shown more success? My ID doc was no help and told me to continue taking the meds as prescribed by the Gi. I appreciate any responses. This has been a tough fight. I’m a mom to 2 young kids and also work in healthcare and have continued to work throughout this ordeal since I’m doing ok on vanco.

[NanciT]

Hello Anib and welcome to the site Please read the first thread for all new posters

There are typical pulse/tapers which we actually have listed here on the site but many doctors have their own. If you have relapsed after Vanco, I would ask for Dificid rather than a Vanco taper although the cost is much less and people have done well.

We can't comment on changing your MD orders, I would suggest asking about Dificid which finally cured me. I did a 3 month Vanco taper which failed. You mentioned you are in healthcare, I am also and I often wonder if I had a very difficult strain. I also failed Dificid( 10 days) but did a taper and it worked!

Take care and feel better soon

NanciT

[roy]

That's another "normal" taper/pulse regime and I would follow my Drs advice.
125mg of vanco is still around 10 times the amount needed to kill c.diff so the regime your Dr has prescribed makes sense.
Especially the 4 weeks at 1 every 3 days (pulse).

Its unusual to start treatment 12 hours after symptoms first start.
C.diff can resolve without treatment.
If you do "relapse" again it might be worth following the 3 day rule.

[Anib]

Thank you for the responses. We did discuss dificid, but my insurance won’t cover it unless I fail vanco taper (actually, I paid cash for vanco bc it was such a hassle to get them to cover it) and given the high cost, I agreed to try this first.
Roy, I will try to stick to his instructions as much as possible and will definitely do a 3rd day pulse x 4 weeks. I agree it was fast, but I felt awful and wanted to have confirmation to know if I should stop the prescribed antibiotics. Prior to this I had been seeing my GI for years due to chronic C, so D was never a problem for me. I tested positive by EIA, pcr and cytotoxin assay at the hospital. I have since lost 15lbs, which is a lot for someone weighing 130lbs to begin with. I’m trying to stay positive that this will work, but have been researching other options including a study on FMT capsules, which I’m on waitlist for in case this fails and dificid doesn’t get approved. I’m hoping I won’t have to worry about that, but you never know with this and I’d rather be proactive. Does anyone have any positive experiences with fmt capsules?

[Fish1]

I failed vanco 125mg 4 times a day. I dont have a GI but my PCP has now prescribed a Vanco Taper that I began this morning. It is 125 mg 4xs a day for ten days. Then 125 mg twice a day for 7 days then 125 mg once a day for 7 days then one tablet every 2 to 3 days for 2 weeks. Does this sound like it’s going to be effective. If not I’d rather try to get the difficid prescription and just bypass Vanco Taper altogether. I put in a message to her but of course this would happen on a holiday weekend. The reason I had the meds on hand is I thought I was having a relapse about ten days ago and went in to see her. Had one bout of diarrhea and because I was leaving town she went ahead and gave me a prescription and i filled it before I left. I never had another episode until three days ago. I waited to start meds until today because I was using the 3 day 3 times a day rule. This time I have more pain that I did initially and the diarrhea has been worse with more clear mucus. I imagine I may have been trying to relapse last week and my good bacteria fought it off for a while but finally had to surrender. I have been taking Florastor probiotic the whole time along with keifer and two yogurts a day. I have always drank keifer and I eat yogurt as well and took Florastor while on the clandimycin but still got it. I just want to know if the taper sounds right or should I just go ahead with difficid. Thanks for any feedback.