A pound of prevention

I don’t know who named the bacterium called Clostridium difficile (more commonly known as C. diff), but they were a master of understatement.

“Difficile” is Latin for “difficult.” But difficult hardly begins to describe the grueling problems that hundreds of thousands of patients face every year with C. diff infections.

C. diff is now believed to be the most common hospital-acquired infection. It causes diarrhea, colitis, and other intestinal problems that are sometimes severe enough to require surgery. And because C. diff infections are most common in older patients, many of whom are already sick, C. diff can be deadly.

C. difficile? More like C. horrendous.

The good news is that there’s a new drug that appears to treat and prevent recurrence of C. diff diarrhea very effectively.

But I have even better news: You can easily protect yourself from this exceedingly “difficult” infection and never have to worry about taking the drug.

Empty wallet syndrome

Just a few days ago, the FDA approved Dificid, the fist new drug in 25 years that treats diarrhea caused by C. diff. Recent trials also show that Dificid is significantly more effective in preventing diarrhea recurrence than the two oral antibiotics that are currently used to treat the condition.

But Dificid has a couple of glaring drawbacks.

In the FDA news release that announced the drug’s approval, the list of “most common side effects” includes nausea, vomiting, and diarrhea. That’s right: Your diarrhea treatment may cause diarrhea.

And then there’s the sticker shock. A 10-day course of Dificid treatment costs $2,800.

But even with the expense and side effects, if you’re laid low by a punishing bout of C. diff, you might be very happy to have a powerful drug at your disposal to treat it.

Needless to say, of course, you’d be happiest not developing C. diff at all.

Fortunately, that can be arranged.

One miserable cookie

There are three important steps to C. diff infection prevention.

Step One: Wash your hands. C. diff spores can live for days on all types of surfaces. So after a visit to a hospital or nursing home, wash your hands thoroughly.

Step Two: Avoid regular use of these three types of drugs have been shown to increase C. diff infection risk:

* Nonsteroidal anti-inflammatory drugs (NSAIDs)
* H2 receptor antagonists (such as Zantac and Pepcid) to treat heartburn
* Proton pump inhibitor drugs (such as Prevacid and Prilosec) to treat heartburn

Step Three: Use a probiotic supplement whenever you’re prescribed an antibiotic.

Antibiotics kill both good and bad bacteria. And low levels of good bacteria provide a perfect environment for C. diff to thrive. This is where a good probiotic supplement can help enormously.

I asked Dr. Spreen if he recommends starting probiotics at the beginning of every antibiotic treatment, and he said, “Yes, absolutely.”

He added that he would continue probiotic use for a full week after the antibiotic is finished. This isn’t overkill — it’s insurance.

Dr. Spreen: “C. difficile colitis is really becoming common, and it’s so sad. The disease is totally iatrogenic while also preventable with probiotic use. I ran into a lady just recently who had an infected catheter, who lost 25 pounds (didn’t have it to lose) from C. diff colitis, and they never even told her the massive antibiotics they gave her could do such a thing. She was one miserable cookie.”

And by the way, in case you don’t know the meaning of “iatrogenic,” it refers to any medical condition that develops as a result of a medical treatment — in this case antibiotics.

Come to think of it, what prescription drug ISN’T potentially iatrogenic?

Sources:
“FDA approves treatment for Clostridium difficile infection” FDA News Release, 5/27/11, fda.gov


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Allan Spreen, M.D.
Dr. Allan Spreen, Chief Medical Advisor

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