Before
I raise alarm, let's get the facts!
C.
difficile is a bacterium that can reside in our intestines and generally will
not cause harm because the normal, healthy bacteria in our in gut will suppress
its growth. The problem arises when we take an antibiotic. The use of antibiotics
for illnesses such as respiratory and urinary infections doesn't only destroy
the infection itself, but also the good bacteria within the intestines. Once
the good bugs are out of the way, the hostile C. difficile can multiply and take
over the intestines.
The
C. difficile bacteria produce toxins that damage the lining of the colon and cause
diarrhea or even severe colitis. The infection can be life threatening, especially
in elderly patients with other health issues. The frequency of having to surgically
remove an inflamed colon has become an increasing occurrence.
Scientists
have discovered that C. difficile infections have not only been increasing, but
are more severe, more difficult to treat, and more likely to relapse. Analyses
of outbreaks have identified a new strain of C. difficile. It is more virulent
because it produces more damaging toxins and is resistant to a commonly-used type
of antibiotic called fluoroquinolones, like Cipro.
Hospitals
have stepped up their surveillance for C. difficile infections and have increased
their efforts at preventing infections. The good news is their programs have been
generally successful.
It
is very important that every patient have an advocate when they enter a hospital
or a nursing home. Sometimes, a patient is unable or unwilling to tell the
nursing staff or doctors that they are having new onset abdominal cramps or diarrhea.
The infection can be missed on a timely basis, which can result in a life threatening
illness.
Additionally,
diarrhea due to C. difficile may not occur until the patient is back at home.
The onset can be delayed weeks which often results in the patient and physician
not recognizing that it could be due to a C. difficile infection that was contracted
at the hospital.
Fortunately,
there are effective treatments for a C. difficile infection. Two antibiotics have
generally been effective in eradicating C. difficile. But again, it is important
to start therapy before a severe colitis develops. The diagnosis can usually be
made rather easily by testing the stools for toxins.
There
have been a number of studies trying to determine if taking a probiotic can prevent
the development of a C. difficile infection. If a probiotic is taken before or
when an antibiotic is initiated, it may be possible to maintain the healthy
bacteria in the intestines to suppress the growth of C. difficile.
A
recent published report(6) reviewed and summarized previous
studies of using probiotics to prevent and treat C. difficile infections. The
report found that some probiotic strains could aid in lessening the risk for
C. difficle infection and may even help to treat an existing infection. More
studies are needed to test other probiotic strains and combinations of strains.
In
the meantime, be aware of this significant, potentially serious side effect of
taking an antibiotic. You may want to consider taking a probiotic like EndoMune
if an antibiotic is prescribed.
Thank
you for your interest in EndoMune.
Eat
healthy, exercise and live well!!
Dr.
Hoberman
1)
NBC Nightly News with Brian Williams: Sept 20, 2008
2) WebMD;Bugs get Deadlier:
May 28, 2008
3) Medscape today; Increase in Adult Clostridium difficile-related
Hospitalizations and Case-Fatality Rate, United States, 2000-2005: June 24, 2008
4)
Science,vol 321; Collateral Damage: The rise of Resistant C. difficile: july 18,
2008
5) Kuipers EJ,Surawicz CM. Clostridium difficile Infection.Lancet 2008;371:1486-88
6)
McFarland LV. Meta-Ananlysis of Probiotics for the Prevention of Antibiotic Associated
Diarrhea and the Treatment of Clostridium difficile Disease. Am J Gastroenterology
2006;101:812-822.
7) MedicineNet.com. C.difficile Epidemic: What You Must Know
September 2008
