C DIFF MENUBARE
TREATMENT
Prevent Clostridium difficile re-infection
- including
other patients, the elderly /immuno-compromised, or those taking antibiotics
Kill C. difficile
(including its spores) on hospital or home surfaces:
Cleaning solutions for C.
Diff
Exercise stringent hand-washing for
patient and patient caregivers
Prevent C. difficile infection
The many spores formed by C. difficile resist
most surface cleaning methods and remain viable outside the body for long periods
of time. Disinfection
with a diluted sodium hypochlorite solution (commonly known as bleach or chlorox)
kills C. difficile
Cleaning solutions for C.
Diff
Certain probiotic strains have shown to prevent antibiotic-associated
diarrhea. There is strong evidence of efficacy
for S. boulardii or L. rhamnosus GG in adults or children who are
receiving antibiotic therapy. Also, recent research has indicated that L. casei
DN-114 001 is effective in hospitalized adult patients for preventing antibiotic-associated
and C. difficile diarrhea.
World Gastroenterology
Williams NT. Probiotics
L. casei DN-114 001 in fermented milk with L. bulgaricus + S. thermophilus
10 billion CFU twice daily
L. acidophilus + B. bifidum (Cultech strains)
20 billion CFU each, once daily
S. cerevisiae (boulardii) lyo
20 billion CFU/day
4 - 20 billion CFU daily for '1-4 weeks
Oligofructose
4 g / three times/day
Lactobacillus rhamnosus strain GG (LGG)
6 -40 billion CFU daily for 1-2 weeks
L acidophilus and L bulgaricus
2 billion CFU daily for 5-10 days
L acidophilus and Bifidobacterium longum
5 billion CFU daily for 7 days
L acidophilus and B lactis
100 billion CFU daily for 21 days
World Gastroenterology Organisation Practice Guideline,
Probiotics and prebiotics, May 2008
Williams NT. Probiotics. Am J Health-Syst
Pharm. 2010;67:449-458 .
Lactobacillus rhamnosus
strain GG (LGG)
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LGG is available in the USas "Culturelle", which is marketed
by CAG Functional Foods and can be bought online.
Gorbach SL, Chang TW, Goldin
B.Successful treatment of relapsing Clostridium difficile
colitis with lactobacillus GG. (Letter) Lancet 1987;2(8574):1519
Saccharomyces boulardii. Numerous
studies have shown S.boulardii an effective treatment for active C.difficile
diarrhea.
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• C. difficile toxin
A-specific antibodies (IgA) in the gut.
Qamar A. Aboudola S, Warny
M, et al.Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response
to Clostridium difficile toxin A in mice.Infect Immun.2001; 69:2672-2765
Lactobacillus acidophilus Lactobacillus casei proprietary blend (50 billion CFU/capsule)
reduced ADD/CDAD in those taking
antibiotics - C. difficile . Randomly assigned to one of 3 groups, patients took dosages
of probiotic blend or placebo (as shown in chart below), begun 36 hours after starting
antibiotic course and continued for 5 days after course was finished. Affect on
antibiotic-associated diarrhea (ADD) or C. difficile -associated diarrhea
(CDAD) was recorded, showing favorable dose-related results for those taking probiotic
blend, compared to those taking placebo. Even those patients who experienced AAD
on probiotics, had symptoms for a shorter duration than those on placebo.
Group
# of capsules
# of CFU
% experiencing ADD or CDAD
Placebo
2 capsules
0
24%
Low dose proprietary probiotic blend
1 capsule
50 billion
10%
High-dose proprietary probiotic blend
2 capsules
100 billion
1.2%
Miller et al, Dose-Response Efficacy of a Proprietary
Probiotic Formula of Lactobacillus acidophilus CL1285 and Lactobacillus
casei LBC80R for Antibiotic-Associated Diarrhea and Clostridium difficile -associated
Diarrhea Prophylaxis in Adult Patients, Am. J. of Gastroenterology, Published online
ahead of print, doi:10.1038/ajg. 2010.11
