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Could I be in trouble. What would you do?

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Ulcerative Colitis
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Posted 11/25/2012 4:53 AM (GMT 0)
Long weekend and no GI that knows me is on call.

I was up all night Wednesday with pain from a skin infection (at least I got most of Thanksgiving cooking done!) Urgent care was closed. In the morning I called the general practice MD on call and he sent me to the ER.

The ER shot me full of rocephin and gave me a prescription for Clindamycin. I'm supposed to take 8! 150 mg tabs a day for 2 days then cut back to 4 a day.

I was warned that clinda wipes out the gut and to take probiotics. The pharmacy said that any probiotic would do so I picked Nature's Bounty advanced Probiotic 10. It has more bacteria and more variety of bacteria than the dozens of others on the shelf. Whatever than means.

I'll get in touch with the GI asap. Meanwhile I am afraid to stop the Clinda, though the infection, while very ugly, does seem to be on the mend. And I am terrifed to continue because the drug is associated with c. diff. Even without c.diff, changing the delicate balance of my gut when I have been doing OK for 4 months could be a disaster.

The only choices are keep going, stop, or switch to another antibiotic that is less harsh. Since I can't write my own prescription my immediate choices are limited.

I am not the only one who has come to the forum for some common sense opinions while waiting out a weekend. Thanks for your thoughts!

Posted 11/25/2012 5:34 AM (GMT 0)
If I was you, definitely call your GI and see if you can use a different antibiotic. Clinda not only promote C. Diff but it can make you flare.
Posted 11/25/2012 7:49 AM (GMT 0)
Whatever antibiotic- if any- that you use, if you do have to take antibiotics, then I strongly recommend that WHILE you take, and immediately after you take, antbiotics, that you take a good- eg double recommended- regimen of OTC s. boulardi. I regularly take Thorne s .boulardi 250 mg caps, and Florastor is a decent one sold in some pharmacies. From the literature it appears that s.boulardi is one of the few probiotics that is not killed off by antibiotics. It certainly wouldnt hurt to hedge your bets with a multistrain regular probiotic taken a few hours apart from probiotics, but i'd take a hefty dose of those after the antibiotic regimen in any case, even if you also took s boulardi during the regimen. As for which multistrain, i'd recommend something with a very high count of CFU's i e in the 50-125 billion range at a minimum, and take a few at a time. vSL3 caps have over 100 billion per capsile vs a few billion for typical pharmacy Brands.
Posted 11/25/2012 1:07 PM (GMT 0)
naturalcurl,

Sorry about this flare that landed you in the ER.

I would definitely suggest you switch to VSL #3DS - get your doc on MOnday to write you some script for it ( 4 sachets per day), DS has 900 billion active cultures.

And start taking it right away, along with like Probiotic said, the s. boulaardi - very important to get as many strains as possible.

Make a cocktail of it, with slippery elm powder too.

Just make sure you leave a 3 hour window between the antibiotics and the probiotics.

 

Posted 11/25/2012 1:18 PM (GMT 0)
I've been on clindamycin twice but not at such a high dose but didn't flare. I took probiotics (triple the amount) two hours after every dose. I've also been on a couple different antibiotics this year and haven't flared. I've had a little loose stool toward the end but just kept up with the nightly enemas and constant probiotics and it went away.
Posted 11/25/2012 5:12 PM (GMT 0)
Thank you everyone! As usual I came to the right place.
To summarize in case it helps anyone else on antibiotics:

Look for S. boulardii (a yeast) as part of probiotics

Look for higher counts. They can differ by a factor of more than 100; 1 billion up to more than 100 billion, and consider taking more than the recommended dose.

Wait a couple of hours after antibiotic to take probiotic to avoid killing off probiotic culture. Good point!!

Look for alternatives to clinda. I am decreasing the does until contact with my GI. My infection symptoms are getting better.

To clarify: I have skin infection and am not in a huge flare. I am very motivated to avoid a flare. As we all know, that would mean the-end-of-normal-life-as-we-know-it.

Any corrections or additions welcome. Thanks again.
Posted 11/25/2012 5:32 PM (GMT 0)
 I wonder if they culture the infection to be sure you have the right anitbiotic?
Posted 11/25/2012 8:49 PM (GMT 0)
I don't know what I would do but it's top priority that you get the infection under control so it may be best to get in touch with your GI, and in the mean time, take what they have given you. It sounds like you're doing better and that's great! hopefully you get by without any UC issues. Even though Clindamyacin can cause a lot of issues, that doesn't mean it WILL. Try to think positive and get in touch with your GI ASAP. You can't wait on treating an infection too long, so you're right, the options are limited :(

I took probiotics while on antibiotics and I got a yeast infection regardless so I guess it wasn't too effective for me lol. Some people say it's best to take probiotics before bed. It seems people all have their methods.
Posted 11/26/2012 5:07 AM (GMT 0)
rey, that's a good question and yes, a culture was taken, the bug is staph, and clinda works against it.

Another good general tip that I got above was to keep taking the probiotics after stopping antibiotics! C. diff can develop some time after antibiotic treatment is stopped.
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