| Standard oral therapy for Clostridum difficile infection | |
|---|---|
| Metronidazole (Flagyl) | 250-500 mg 3 or 4 times daily X 10-14 days |
| If unsuccessful, then Vancomycin (Vancocin, Vancoled) | 125 mg 4 times daily X 10-14 days |
| To speed up success and shorten duration of diarrhea, concurrently
take a probiotic supplement containing strains known to "put a hurtin' on" C. Difficile. Take probiotic at least 2 hrs away from antibiotics. These include: • Saccharomyces boulardi (Florastor); • Lactobacillus acidophilus and Bifidobacterium spp. (Dr. Mercola Complete probiotics); • Lactobacillus rhamnosus GG (LGG) (Culturelle). It is advisable to take a quality, multistrain probiotic after the standard therapy and continue for at least 6 weeks to restore normal GI tract flora. E.g. Dr. Mercola® Complete Probiotics Also, include natural food probiotics and prebiotics in your diet. |
Minimum 50 billion CFU /day (multi-strain/high production quality) X 42 days |
| Some therapy Choices for recurrent Clostridium difficile infection | |
|---|---|
| (From germination of intestinal spores that "escaped"standard therapy or reinfection) | |
Oral vancomycin therapy |
|
| Tapering Vancomycin (shown to be effective) | 125 mg 4 times/day X 7 days;125 mg twice daily X 7 days;125 mg once daily X 7 days;125 mg every other day X 7 days125 mg every third day X 14 days |
| Vancomycin PLUS |
125-250 mg 4 times/day X 14 days |
| Rifampin | 150-300 mg twice/day X 14 days |
| or Bacitracin | 25,000 U4 times/day X 14 days |
| Oral Anion-binding substances (binds C. difficile toxins) |
|
| Anion-binding resin: Cholestyramine (LoCHOLEST, Prevalite, Questran)
slows fecal transit time but also binds C. difficile toxins (Cholestyramine
alternative: Eat a banana or banana flakes twice a day) PLUS |
4 g 3-4 times/day X 14 days (but avoid constipation)Must take medications 3 hours apart because the resin of cholestyramine can bind vancomycin |
| Vancomycin | 125-250 mg 4 times/day X 14 days |
|
Bentonite clay or
Activated
charcoal PLUS |
See links for dosages / Avoid constipation |
| Vancomycin | 125-250 mg 4 times/day X 14 days |
| Oral probiotic therapy | |
| Saccharomyces boulardii PLUS |
500 mg twice daily for 4 weeks |
| Vancomycin (Vancocin, Vancoled) Reduced relapse rate by 50% in randomized placebo-controlled trial - well tolerated. |
125 mg 4 times/day for 10-14 days |
| Vancomycin (Vancocin, Vancoled) Then after Vancomycin course: Lactobacillus GG (Culturelle, Lactinex) |
125 mg 4 times/day for 10-14 days100 billion organisms 4 times/day X 7-14 days |
| Continued Probiotic Therapy | |
| It is advisable to follow any of the above therapies by taking a quality probiotic supplement for a month or two to restore normal GI tract flora. E.g. Dr. Mercola® Complete Probiotics | Minimum 50 billion CFU /day (multi-strain/high production quality) x 30-60 days |
