jerrie97
01-21-2004, 06:45 PM
Can taking cholestyramine while on antibiotics prevent C. diff colitis? The reason I ask is because of chronic lung infections and frequent antibiotic usage. I've been on antibiotics 10+ times this year.
Also, is there any chance that I'd be approved for inhaled Tobramycin? I know it's only indicated for CF patients, but my infectious disease doctor suggested it..
Also, is there any chance that I'd be approved for inhaled Tobramycin? I know it's only indicated for CF patients, but my infectious disease doctor suggested it..
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Bruce
01-22-2004, 12:06 PM
Can taking cholestyramine while on antibiotics prevent C. diff colitis? The reason I ask is because of chronic lung infections and frequent antibiotic usage. I've been on antibiotics 10+ times this year.
Also, is there any chance that I'd be approved for inhaled Tobramycin? I know it's only indicated for CF patients, but my infectious disease doctor suggested it..
The answer to your first question is no. The drug of choice is oral Vancomycin to treat C. difficle toxin. This disorder has the potential to be a serious infection, including intestinal bleeding.
Tobramycin is used for serious gram negative bacilli infections, To inhale the drug you need a clear, plastic tent plus a device that would produce a mist.
This procedure is commonly used in hospitals, especially the pediatric ward for cf patients. :wave:
Also, is there any chance that I'd be approved for inhaled Tobramycin? I know it's only indicated for CF patients, but my infectious disease doctor suggested it..
The answer to your first question is no. The drug of choice is oral Vancomycin to treat C. difficle toxin. This disorder has the potential to be a serious infection, including intestinal bleeding.
Tobramycin is used for serious gram negative bacilli infections, To inhale the drug you need a clear, plastic tent plus a device that would produce a mist.
This procedure is commonly used in hospitals, especially the pediatric ward for cf patients. :wave:
Bruce
01-22-2004, 12:14 PM
I forgot one more antibiotic used for C. diff. toxin, metronidazole (Flagyl)
Ratatosk
01-22-2004, 04:24 PM
Tobramycin is used for serious gram negative bacilli infections, To inhale the drug you need a clear, plastic tent plus a device that would produce a mist. This procedure is commonly used in hospitals, especially the pediatric ward for cf patients. :wave:
We use it via a nebulizer -- my son has pseudamonas a. They're very specifiic on the type of neb cup to use. Treatments take about 25-30 minutes, so the whole room gets foggy. He's supposed to inhale it by mouth and nose clips are provided; however, he's not even a year old, so we use a mask. He's on for 28 days, then off for 28. Guess there've been some studies that show if used in small children before the age of 6, tobi can actually irradicate the infection.
We use it via a nebulizer -- my son has pseudamonas a. They're very specifiic on the type of neb cup to use. Treatments take about 25-30 minutes, so the whole room gets foggy. He's supposed to inhale it by mouth and nose clips are provided; however, he's not even a year old, so we use a mask. He's on for 28 days, then off for 28. Guess there've been some studies that show if used in small children before the age of 6, tobi can actually irradicate the infection.
jerrie97
01-22-2004, 05:26 PM
I thought that cholestyramine binded to Clostridium difficile and got it out of the system quicker. Or something.
Haemophilus influenzae is gram-negative, right? This is what I'm always growing, sometimes with Strep pneumoniae.
Haemophilus influenzae is gram-negative, right? This is what I'm always growing, sometimes with Strep pneumoniae.
Bruce
01-22-2004, 08:30 PM
I thought that cholestyramine binded to Clostridium difficile and got it out of the system quicker. Or something.
Haemophilus influenzae is gram-negative, right? This is what I'm always growing, sometimes with Strep pneumoniae.
The answer to your first question is still no. After taking antibiotics, if you carry the C. difficle, it will over grow and produce more of the toxin, and you could have a bloddy, painful diarrhea. If you have symptoms resembling these, call your doctor right away.
Tobramycin is usually used to treat enteric gram negative bacilli such as Pseudomonas or klebiella. Blood levels must be performed if it is given IV or IM because it is toxic at higher levels.
For H. influenza, ampicillin used to work, but the organism has cecome resistent. The drugd now used for serious infections is chloramphenical or ceftriaxone (Rocephin).
:angel:
Haemophilus influenzae is gram-negative, right? This is what I'm always growing, sometimes with Strep pneumoniae.
The answer to your first question is still no. After taking antibiotics, if you carry the C. difficle, it will over grow and produce more of the toxin, and you could have a bloddy, painful diarrhea. If you have symptoms resembling these, call your doctor right away.
Tobramycin is usually used to treat enteric gram negative bacilli such as Pseudomonas or klebiella. Blood levels must be performed if it is given IV or IM because it is toxic at higher levels.
For H. influenza, ampicillin used to work, but the organism has cecome resistent. The drugd now used for serious infections is chloramphenical or ceftriaxone (Rocephin).
:angel:
butterflytrans
01-25-2004, 02:00 AM
They still use chloramphenicol where you work bruce?!! Now THERE's a drug who you don't hear about that much anymore (where I'm from at least :) )
I have also heard that taking cholestyramine while on antibiotics seems to lower the incidence of C. difficile overgrowth, but from my impression, these were just some anecdotal observations and I'm not sure if this point has been formally studied. I think the original person who wrote this thread meant that the cholestyramine PREVENTS overgrowth of C. diff while on antibiotics, and not necessarily helping to eliminate it if it does overgrow.
I have also heard that taking cholestyramine while on antibiotics seems to lower the incidence of C. difficile overgrowth, but from my impression, these were just some anecdotal observations and I'm not sure if this point has been formally studied. I think the original person who wrote this thread meant that the cholestyramine PREVENTS overgrowth of C. diff while on antibiotics, and not necessarily helping to eliminate it if it does overgrow.
Bruce
01-25-2004, 01:02 PM
They still use chloramphenicol where you work bruce?!! Now THERE's a drug who you don't hear about that much anymore (where I'm from at least :) )
I have also heard that taking cholestyramine while on antibiotics seems to lower the incidence of C. difficile overgrowth, but from my impression, these were just some anecdotal observations and I'm not sure if this point has been formally studied. I think the original person who wrote this thread meant that the cholestyramine PREVENTS overgrowth of C. diff while on antibiotics, and not necessarily helping to eliminate it if it does overgrow.
Chloramphenicol sort of got a bad rap years ago, but it is still used in serious infections.
C. diff. is very resistent to many antibiotics, and is likely to overgrow in the GI tract if the patient is a carrier.
I still wouldn't want to rely on cholestyramine to treat pseudomembranous colitis. You could, if a severe infection, end up with a perforated bowel, and that could be fatal.
I have also heard that taking cholestyramine while on antibiotics seems to lower the incidence of C. difficile overgrowth, but from my impression, these were just some anecdotal observations and I'm not sure if this point has been formally studied. I think the original person who wrote this thread meant that the cholestyramine PREVENTS overgrowth of C. diff while on antibiotics, and not necessarily helping to eliminate it if it does overgrow.
Chloramphenicol sort of got a bad rap years ago, but it is still used in serious infections.
C. diff. is very resistent to many antibiotics, and is likely to overgrow in the GI tract if the patient is a carrier.
I still wouldn't want to rely on cholestyramine to treat pseudomembranous colitis. You could, if a severe infection, end up with a perforated bowel, and that could be fatal.
butterflytrans
01-25-2004, 03:16 PM
Well, let's not get ahead of ourselves here. A perforated bowel from C. diff infection almost only happens if someone has toxic megacolon--not just psedomembranous colitis. If it were the latter, then every patient on the medicine ward would need surgery ;) . But Bruce, I still think you're missing the point. It's not being suggested that one use cholestyramine to treat C. diff infection or the subsequent P. colitis that can occur....it's bein suggested that cholestyramine be given with the original antibiotics (i.e. clindamycin in most cases) so that C. diff doesn't occur in the first place...i.e. prophylaxis.
Bruce
01-27-2004, 06:02 PM
Can taking cholestyramine while on antibiotics prevent C. diff colitis? The reason I ask is because of chronic lung infections and frequent antibiotic usage. I've been on antibiotics 10+ times this year.
Also, is there any chance that I'd be approved for inhaled Tobramycin? I know it's only indicated for CF patients, but my infectious disease doctor suggested it..
Note the question above: Can taking cholestryamine while on antibiotics prevent C. dificle?
I am not allowed to post references, but please read the following: cholestyramine: "for mild cases or relapse. response varies and is generally low".
side effects: constipation, heartburn, vomitting, stomach pain, headache and diarrhea.
Their are many degrees of symptoms with C. difficle, from mild to severe.
"For fulminent toxic cases that don't rerspond after a week of intensive therapy becausethe risks of perforation increases after seven days of ineffective therapy, an early subtotal colectomy is recommended.
Also, is there any chance that I'd be approved for inhaled Tobramycin? I know it's only indicated for CF patients, but my infectious disease doctor suggested it..
Note the question above: Can taking cholestryamine while on antibiotics prevent C. dificle?
I am not allowed to post references, but please read the following: cholestyramine: "for mild cases or relapse. response varies and is generally low".
side effects: constipation, heartburn, vomitting, stomach pain, headache and diarrhea.
Their are many degrees of symptoms with C. difficle, from mild to severe.
"For fulminent toxic cases that don't rerspond after a week of intensive therapy becausethe risks of perforation increases after seven days of ineffective therapy, an early subtotal colectomy is recommended.
Bruce
01-27-2004, 06:25 PM
Well, let's not get ahead of ourselves here. A perforated bowel from C. diff infection almost only happens if someone has toxic megacolon--not just psedomembranous colitis. If it were the latter, then every patient on the medicine ward would need surgery ;) . But Bruce, I still think you're missing the point. It's not being suggested that one use cholestyramine to treat C. diff infection or the subsequent P. colitis that can occur....it's bein suggested that cholestyramine be given with the original antibiotics (i.e. clindamycin in most cases) so that C. diff doesn't occur in the first place...i.e. prophylaxis.
Now who is getting carried away. I didn't misread the question ( see my last post). Nothing was said about prophylaxis. and no body said anything about performing surgery on all the patients on the "medicine ward.
You are way of base with your criticisms and my imprerssion is you do it to make me look bad.
I rerpeat, the symptoms of C. difficle toxin can range fro mild to severe. What is it you don't understand? I have performed my share of C. difficle toxin tests, and many of the specimens were watery and bloody. Are you going tp tell me i didn't see these nasty specimens or dreamed it up?
Clindamycin is not the only antibiotic that causes pseudomembranous colitis (meaning C. difficle if you didn't get it.
Frankly i have had it with you. Why don't you try and help people instead of ctriticising me?
Now who is getting carried away. I didn't misread the question ( see my last post). Nothing was said about prophylaxis. and no body said anything about performing surgery on all the patients on the "medicine ward.
You are way of base with your criticisms and my imprerssion is you do it to make me look bad.
I rerpeat, the symptoms of C. difficle toxin can range fro mild to severe. What is it you don't understand? I have performed my share of C. difficle toxin tests, and many of the specimens were watery and bloody. Are you going tp tell me i didn't see these nasty specimens or dreamed it up?
Clindamycin is not the only antibiotic that causes pseudomembranous colitis (meaning C. difficle if you didn't get it.
Frankly i have had it with you. Why don't you try and help people instead of ctriticising me?
jerrie97
01-27-2004, 07:40 PM
It's probably my fault for not making the question clearer. I've read that cholestyramine may be used in conjunction with Vancomycin to clear the colitis quicker, but I was asking if prophylactic therapy with cholestyramine has ever been heard of. For example, say I got bronchitis and was given another round of...say, Augmentin. Would I have less of a chance of developing C. diff colitis if I took cholestyramine? Or would my risk remain the same? Sorry for the confusion.
Also, why do Clindamycin and Lincomycin seem have an increased incidence of c. diff infection?
Also, why do Clindamycin and Lincomycin seem have an increased incidence of c. diff infection?
butterflytrans
01-30-2004, 01:57 AM
The reason cholestyramine can help in preventing a C. difficile infection, and also blunting the effects of an infection if it does happen is because cholestyramine binds to the "A toxin" that C. difficile produces. This helps sequester it, preventing it from having negative effects on the body.
...and the reason clindamycin often can result in C. diff overgrowth is because it is not absorbed that well, and it tends to kill a lot of the normal flora that is present in the gut--much more so than other antibiotics. This, of course, allows the C. difficile to overgrow.
...and the reason clindamycin often can result in C. diff overgrowth is because it is not absorbed that well, and it tends to kill a lot of the normal flora that is present in the gut--much more so than other antibiotics. This, of course, allows the C. difficile to overgrow.
Administrator
02-20-2004, 01:52 PM
Both of you need to stop the medical bantering:
This is a support forum. Not a professional advice forum.
Your medical expertise is not the point of this website, so
either get into the purpose of the site, or don't answer.
Thank you!
mod1
This is a support forum. Not a professional advice forum.
Your medical expertise is not the point of this website, so
either get into the purpose of the site, or don't answer.
Thank you!
mod1