The comedy of medical errors continues after the myelogram/CT scan on May 21st designed to gather information about my neck and back. That intervention resulted in a case of bacterial meningitis, hospitalization, and ten days on a strong, broad spectrum (kills most everything) antibiotic called ceftriaxone administered via infusion through a PICC line. The meningitis was vanquished and the PICC line pulled. But then a secondary infection took root.
One of the listed side effects for cephalasporin antibiotics like ceftriaxone are that they kill many of the helpful bacteria living in the gut but do not kill potentially harmful microbes including one called Clostridium difficile or C diff. Symptoms of C diff include the following:
- Watery diarrhea (at least three bowel movements per day for two or more days)
- Loss of appetite
- Abdominal pain/tenderness (Center for Disease Control and Prevention)
There is a lab test for the bacteria (don’t ask about how it is obtained). When C diff bacteria gain a foothold in the intestines, they release toxins that damage the intestines (colitis) and the toxins can get into the bloodstream. Dehydration is a major concern. It is a spore forming bacteria and the spores are difficult to kill. It is a common infection in hospitals and other health care facilities and is especially problematic in elderly, unhealthy, and immunocompromised patients (hey, that last one is me!). Over 500,000 Americans get C diff annually with almost 30,000 deaths associated with the infection annually. C diff is now seen as a more serious hospital related infection risk than even the much-feared MRSA staph bacteria.
Treatment for C diff starts with an antibiotic. Metronidazole, or Flagyl, is usually the first line antibiotic used for C diff. But my infectious disease docter went straight to the second line antibiotic, vancomycin, when he learned that I take Rituxan for RA and am immunocompromised. I’m currently taking an oral version of vanco. Up to 20% of patients relapse after the first round of antibiotics and must take additional rounds. If the good bacteria are wiped out, then it stands to reason that probiotics may be helpful in repopulating these flora. The research results on probiotics for C diff are mixed but my doctor recommended that I take them. I opted to take a medical grade probiotic called VSL #3. There are published research studies that the bacteria strains in VSL #3 help colitis symptoms. It’s available at many pharmacies but is kept behind the counter in a refrigerator.
It seems that RA is the gift that keeps on giving. I’ll just be glad to move onto the more “traditional” primary RA issues!