C. Difficile overgrowth and now 4 weeks pregnant

[PregnantGal]

I finished 10 days of Metronidazole for c.difficile overgrowth on November 11th.   On Nov 13th, I found out I am pregnant and according to calculations I am just over 4 weeks pregnant now. My due date is approx. July 21st, 2005.  



I am sure the c.diff is back as I had bloody mucousy runny stool this morning.



How dangerous is it for me to have c.diff while pregnant? What drugs are safe to take to get rid of it during my pregnancy, and what is your recommended course of action?   Should I just tough it out with c.diff past the first trimester and take the second round or metronidazole in the second trimester?  What if I need to take vancomycin because the second round of flagyl does'nt work?  What foods should I eat and avoid?  Can I take natural remedies?



I am open to abortion if my health or the baby's health is severely compromised due to c.diff but that is a last resort.



Thank you.

[Kevin Pho, MD]

Flagyl is a class B medication (no evidence of risk), Vancomycin is a class C medication (meaning that risk cannot be ruled out).  I would consider the Flagyl only in conjunction with your OB/GYN physician, but that would be the optimal antibiotic if CDiff is present.  



I am not aware of an association between CDiff and diet.  Regarding natural remedies, there is no data supporting that they work.  If you want to try that approach, this should be discussed with your OB.  



Followup with your personal physician is essential.



This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.



Kevin, M.D.

Medical Weblog:

kevinmd_b

[Bibsy]

I am so sorry you are going through this while pregnant. I have been suffering with recurrent c-difficile for a year. I was treated with Flagyl first, then subsequent relapses have been with Vancocin. Vancocin is not absorbed into the bloodstream like Flagyl and so would think that is the drug of choice for someone who is pregnant that comes down with c-diff. There is a wonderful support group online: www.cdiffsupport.com

If not for that site, I don't know where I would be. I am currently doing fine on a tapering dose of Vancocin...1 every three days. Will go to one every four soon. I have found an infectious disease doctor who has some ideas if I relapse again....Do not despair..Most people who develop c-diff are cured after their first or second round of Flagyl or Vanco. Be sure and talk to your gyn-ob about this and probiotics have helped me alot.



Good luck and pray you are over this soon....



Beverly

[PregnantGal]

Thank you so much for your kind words.  How awful you have been suffering with c.diff for so long.  This is such a worry for me right now, especially just finding out I am pregnant.  I will go to that support website and check it out, thank you.  I did not know that about the vancocin(that it's not absorbed by the blood), so maybe my dr. will prescribe that next if my test comes back positive again.  I am submitting another stool sample tomorrow or Tuesday and hopefully will get in to see my GP later this week.  



Thanks again, and thank you especially for your prayers.  :)

[Med_Writer]

There may yet be a "proven" natural remedy for C. difficile colitis, but I'm not sure about its safety in pregnant women.



The yeast known as Saccharomyces boulardii may be a safe, effective alternative. Used either alone or in combination with vancomycin, it has been reported to be an effective therapeutic alternative for recurrent C. diff infection.



S. boulardii is a beneficial yeast sold under the brand name Florastor in many drugstores. Be sure to ask the pharmacist about it. There might be dosing adjustments you need to make. For example, the worse your diarrhea, the faster S. boulardii will be eliminated from your system, so you may have to increase the dose or take it for a longer time than a healthier person. One study found an end to disease recurrences in 85% of patients who took S. boulardii for 30 days.



S. boulardii is generally well tolerated and harmless (unless you have HIV/AIDS or other serious immune-compromising condition). But if I were pregnant I would take anything without first discussing it with an informed healthcare provider.



Do some research on it for yourself and see.



-MW

[PregnantGal]

Thanks!!!  I am going to the doctor again today and will ask her about it.  I find that most doctors I have been to in the past don't really know anything about OR support alternative methods of treatment that are not pharmaceudicals.  It's frustrating.



I will look into it !  Thanks again!  

[krim1]

A related discussion, diarrhea was started.