Cipro and C Diff

[beccakb]

Hi all,

I had two bouts of c diff in 2020 - first one was caused by a combination of antibiotics (clindamycin, amoxicillin, and a UTI based antibiotic) and treated wit Vanco. I relapsed a month later, did another round of Vanco (my body decided to also have a lovely hive reaction to Vanco that time) and I haven't relapsed since.

I now have some kind of bacteria (Enterococcus faecalis) that came up on a vaginal panel and my doctor want to treat with Cipro based on my allergic reactions to penicillin-based antibiotics. However, I'm reading up on this forum about people's poor reactions to Cipro. So I'm clearly concerned.

But the more I read about this bacteria, the more I'm concerned about it as well. It is very antibiotic-resistant and so only strong courses of antibiotics do the trick (hence the Cipro). I'm two years out since my last C diff relapse - I want to believe I am safe and can take the Cipro and monitor any bowel symptoms. But obviously I'm anxious and the timing for a c diff relapse right now is so not ideal with some travel-related work stuff I have coming up.

I'm waiting for my GI doctor to call me back about their opinion of other antibiotics for this bacteria. But has anyone been able to take Cipro without a c diff relapse if you have a history of c diff? I'm afraid my OB doctor doesn't know enough about C Diff to help me out much so I'm relying on my GI doctor to get back to me. Just nervous about a new antibiotic and the possibility of a relapse.

[georgina]

You are never safe when you have been a ex-Cdiff-er and you need to take another course of antibiotic , there is no safe antibiotic for u to take ,although some antibiotics are safer then others.For example Cipro is in the red zone , is a high offender so it comes with great risk for u to get Cdiff back . There is a list under CDI about antibiotics , you should take a look at it.
If Cipro is your doctor's ONLY option then look for a good probiotic , eat a easy to digest diet during the treatment ,stay away from irritants like alcohol and sugar , pray and maybe things will go well.

[GtrGrl]

I wonder if E Faecalis would respond to a topical treatment instead. Worth asking?

[beccakb]

Thank you both for the reply. I just got off the phone with my OB's PA, and they noted the E. faecalis is a very antibiotic-resistant strain and that Cipro ends up being pretty much my only antibiotic option. I'm going to meet with the OB in person hopefully before Friday to discuss this more and will talk about possible topical options instead of oral antibiotics. I've got that CDC article to give to the OB for reference.

Will update with what the antibiotic choice will be.

[beccakb]

Well I guess no I'm not - of course I can't get in with the OB for over a week.

So I think I'm stuck with taking the Cipro. Any extra advice on how to prevalent c diff as best as possible through this is welcome. I'm on Florastor, going to reduce sugar intake, eat a bland diet. And pray a lot.

[Lissaucd]

I would ask for the department head of OBGYN to contact the GI doctor before prescribing cipro and include you in the meeting/ correspondence. Tell them you are requesting an immediate appointment this week given your history with cdiff. If they don’t fit you in, go above them. Or ask them to do an email correspondence within 24 hours and include you. I just hate it when individuals can’t get the help or guidance they need. I’m so sorry. I’m not sure, but others on this site have mentioned have used vanco, dificid at the same time of taking antibiotics to help prevent cdiff. I would 100% ask about it when you talk to your docs!

[beccakb]

Thank you for all of that advice! It is incredibly frustrating working with this healthcare system sometimes...

I called my OB this morning to see if there were any cancellations I could get in with and there was thankfully! I met with the OB and sure enough this strain of E. faecalis is resistant to literally every antibiotic except Cipro. Thankfully the "count" of how much of this bacteria is present is not incredibly high and I have a good amount of good vaginal bacteria present. For the time being I'm going to hold off taking the Cipro until I can get in with my GI doctor and discuss options of how to deter a c diff relapse with this antibiotic. OB was on board with me holding off on the Cipro based on the lower count of the E. faecalis.

I'll keep this forum updated since I have really benefited from going back through old threads regarding Cipro and C diff.

[GtrGrl]

I too may have to take cipro as I just received my urine lab report back. Got leukocytes as well as some stubborn bacteria so think will prob have to treat. Will ask about antibiotic instillations first, though I think I’ll be lucky to get that. Please do post updates, Becca.

[NanciT]

It's good they checked the bacteria count, very important. My Urologist does not treat a UTI for me if it is low....may still be positive but the count is important and then we wait and watch symptoms etc.

I also want to mention if possible try and get an ID on board.....I finally did in 2020 after getting CDIFF again 5 years . He is very specific on what antibiotics to treat with.

Hope you feel better soon

NanciT

[beccakb]

Wanted to provide an update on this Cipro/C Diff discussion.

I took the Cipro about 3 weeks ago and did not experience any C diff symptoms or stomach symptoms in general which I was super surprised about. I did experience some tendon-based pain, but I had underlying tendinitis that I assumed would get more inflamed with this medication. But a major hooray for no C diff reoccurrence with the Cipro!

However, of course my medical issues are never truly "over"....I have yet again another BV infection. Last time I had one was pre-C diff and was prescribed Clindamycin (as I'm allergic to Flagyl) and the Clindamycin is what started my C Diff. So I'm sure as heck not doing Clindamycin again.

Very annoying there's no other antibiotics for BV. Trying to treat with probiotics and suppositories. Sometimes I can get BV symptoms to go away on their own with some patience on my end so fingers crossed.

[beth22]

Thanks for the update and happy to hear you did not relapse. I would definitely stay away from clindamycin as well.

[GtrGrl]

Becca, you may already have come across it but this site is an excellent source of info:

https://myvagina.com/bacterial-vaginosis/

I am so pleased that you managed to get through the cipro without relapsing; did it help? They mentioned clindamycin on my latest clinic letter as well, and the consultant told me I can 'just take metronidazole' if the C Diff comes back. Obviously she is not up to date on what meds to use but also: the attitude! Most of these people have no idea what it feels like to have C Diff! So I don't know what to do; I am getting some more tests done but I am symptomatic. I can't do nothing,