As I noticed more symptoms of depleted good bacteria, I began to wonder whether I want to continue full strength (4x125mg daily) doses of vancomycin for another week. So I researched 'pulse dosing for recurrent c-diff' and found a JAMA article which referenced a local study. They had good results with prolonged tapering pulse dosing with vancomycin in patients with 2 recurrences of c-diff. The author of the JAMA article described a longer schedule than I had planned. He used the initial 2 weeks of vanco 4x daily, then one week of vanco every 12 hours (2x daily), then a week of once daily, then 8 days of vanco every other day (4 total doses), and finally 1 vanco every 3rd day for 5 doses (total 15 days).
I don't have time before my vacation to do the once every 3rd day regimen and still follow the vanco treatment with a week of high doses probiotics. So I'll just do the first 3 parts of the prolonged tapered plan and follow that with a week of probiotics. Although I've taken a lower dose probiotic every day that I take vanco, my symptoms of frequent bruising and intense bloating reaction to that one probiotic capsule indicate that my good bacteria are very low right now. So I definitely want to follow my vanco pulse dosing regimen with the high dose probiotics to quickly restore my good bacteria levels before I leave for my vacation.
I emailed my doc the JAMA article and the research abstract ("Breaking the cycle: treatment strategies for 163 cases of recurrent Clostridium difficile disease"). At this point I'm teaching my doctor much more than he previously knew about c-diff treatment, recurrence and pulse dosing. I finally see a purpose for as well as an end to my c-diff experience.
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5 comments:
This is good news, Sue. I hope you are able to work out a dosing schedule that works for you. I also hope your trip to Maui is a good one. I know you often enjoy good health there! :) I'll read the rest now... doing it backwards!
Thanks, Lisa. Right now I'm doing one vancomycin every 12 hours (or 2x daily). I don't notice a lot of difference, probably because I used to go almost 11 hours from late night dose until breakfast dose the next morning. So maybe my c-diff spores already got wise to the 12 hour delay. Nevertheless, I'll stay on 2x daily this week. Then on Satuday I'll start 1x daily. Then the following Saturday I'll start once every other day. Then I'll do really high dose probiotics for a week.
If you read previous posts about c-diff and vanco, you'll notice I changed my mind about doing another 2 week of 4x daily before starting tapered doses. I decided to just dive into tapered doses, because I'd already done 2 wks of vanco.
I suspect I had previous recurrences because I didn't use tapered doses to treat spores. I just stopped after one week or 10 days and stayed off about a week before c-diff symptoms were obviously back. So the spores had a chance to repopulate without antibiotic intervention.
Hopefully pulse dosing will allow the spores to morph into bacteria and get zapped by intermittent vanco doses. At least that's what one study demonstrated with 161 c-diff patients with at least 2 recurrences. Keep me in your prayers. I hope this works!
Hi sue,
I am a Doctor myself and i am treating myself, its amazing how you learn when you treat yourself, i am caught with C diff and i have had several relapses, i am tired of the antibiotic and i am sure going to try the pulse dosing technique. Hope it works......cause as you would also know how pathetic this thing gets.
Hi Amit:
I did the tapered and pulse dosing technique twice. The first time I didn't 'taper' long enough. The second time, I 'pulsed dosed' for a month or so. My next 2 stool tests were free of c-diff. So I know that technique works even after my 6 c-diff recurrences.
Here's a link to the study which showed the effectiveness of tapered and pulse vancomycin dosing for recurrent c-diff:
http://www.nature.com/ajg/jounral/v97/n7/abs/ajg2002451a.html
I believe I posted in this blog the exact method I used for tapered and pulse vancomycin dosing. If you don't find that post in this blog, let me know. I can describe in detail the exact method after doing that twice!
Sorry. I misspelled journal in that link and the post dropped part of the address. I'll try again here:
http://www.nature.com/ajg/journal/
v97/n7/abs/ajg2002451a.html
That's all one line, but I broke it up to post the whole thing. Let's see if that worked.
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