Flagyl and Cipro ???? Please reply someone!
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brboatwright
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Flagyl and Cipro ???? Please reply someone!
OK. I had the CT Scan on Monday and on Wednesday went for my followup visit. CT was done really well in my opinion, they took several shots, way more than I ever had once in the past. Ct Showed no Abscess (yeah!) and nothing else....The only thing it showed was severe inflammation in the terminal ileum?!! hmmmm.... The inflammation was worse so this is why I was so miserable. I am in the second week of taking 20 MG of prednisone 1 X day and I must admit, this is the first time I have been pain free since 08/2007. UNBELIEVABLE! Although my doctor is wanting me to start weaning of this week. 15MG prednisone for two weeks then 10MG Prednisone for 2 weeks while starting 3 tablets of entocort back up. She also wants me to start taking Cipro and Flagyl for the next two weeks before I start the last two weeks of Prednisone which is the first two weeks of entocort. (Is that confusing or what). Anyway.....my question is this.. I have read so many posts about C.Diff. I have never been tested. Should I be concerned about starting these antibiotics. I read that the flagyl is used to treat C. Diff, but the Cipro can cause C.Diff...so and if I do have C.Diff will I be OK. I am scared to start these medications because I feel pretty good, but I want to go into remission and want to listen to the doctors order in an effort to get rid of this DARN inflammation. Please reply someone........
32 YR OLD/ DAYTON, OH - Crohns only in terminal Ileum - Diagnosed 10/2008
Hi Bethany,
I'm glad to "hear" that the scans turned out so well, and you're feeling much better. If no abscesses were found, and you haven't recently been tested for C. diff, I don't understand why your doctor would prescribe an antibiotic. It may be a "just-in-case" precaution, but as you are well aware, taking antibiotics when they are not needed, can sometimes be an invitation to disaster.
Actually, we have found Ciproflaxin to be one of the least risky antibiotics for us, as a group. Although just about any antibiotic can lead to a C. diff problem, under certain conditions, the greatest risk seems to come with clindamycin (Cleocin), ampicillin (Omnipen), amoxicillin (Amoxil, Augmentin, or Wymox), and any antibiotics in the cephalosporin class, (such as cefazolin or cephalexin). Clinical symptoms of the problem can appear during the antibiotic treatment, or any time up to four weeks after the treatment has stopped.
Therefore, if you have had an antibiotic treatment within the last month, your doctor may be prescribing these antibiotics, based on a "hunch" that you may have C. diff. I hope not, because that would be somewhat unprofessional, under the circumstances . A C. diff treatment should be initiated only when a patient has actually tested positive to a C. diff culture test, except possibly under very special circumstances.
Maybe the antibiotics are being prescribed for some other reason, such as a UTI, or some other infection that she thinks you might have. If that's the case, though, surely she would have told you why she's suggesting that course of treatment.
This may be what she has in mind: We have found that Cipro will actually stop a flare, with MC, virtually 100 % of the time, so maybe it will also stop a flare with Crohn's. That could be the reason why she is prescribing the Cipro. Since that could possibly open the door to a risk of C. diff, she may be prescribing the Flagyl, to preempt that possibility.
The problem with this plan is that a few days, (or a week or so), after stopping the Cipro, the symptoms will return, and you can't keep taking Cipro for long-term use, because of various reasons, not the least of which is a risk of tearing your Achilles tendons, (or tendons at other locations in the body).
Prednisone, (and budesonide), will not affect C. diff, so if you are symptom free, (no diarrhea), then you do not have C. diff. If, however, you do go ahead with the antibiotic treatment, I would advise that you begin taking a good probiotic, starting just before the antibiotic treatment ends, and continuing for at least a couple of weeks or so, in order to help prevent any stray C. diff bacteria from recolonizing your gut, which will be very vulnerable, just after the the antibiotic treatment ends. I'm no doctor, though, so all I can offer is my personal opinion, based on our experiences here.
Like you, I'm puzzled as to why she wants you to take the antibiotics, but maybe she has information about a possible infection that we're not aware of.
Tex
I'm glad to "hear" that the scans turned out so well, and you're feeling much better. If no abscesses were found, and you haven't recently been tested for C. diff, I don't understand why your doctor would prescribe an antibiotic. It may be a "just-in-case" precaution, but as you are well aware, taking antibiotics when they are not needed, can sometimes be an invitation to disaster.
Actually, we have found Ciproflaxin to be one of the least risky antibiotics for us, as a group. Although just about any antibiotic can lead to a C. diff problem, under certain conditions, the greatest risk seems to come with clindamycin (Cleocin), ampicillin (Omnipen), amoxicillin (Amoxil, Augmentin, or Wymox), and any antibiotics in the cephalosporin class, (such as cefazolin or cephalexin). Clinical symptoms of the problem can appear during the antibiotic treatment, or any time up to four weeks after the treatment has stopped.
Therefore, if you have had an antibiotic treatment within the last month, your doctor may be prescribing these antibiotics, based on a "hunch" that you may have C. diff. I hope not, because that would be somewhat unprofessional, under the circumstances . A C. diff treatment should be initiated only when a patient has actually tested positive to a C. diff culture test, except possibly under very special circumstances.
Maybe the antibiotics are being prescribed for some other reason, such as a UTI, or some other infection that she thinks you might have. If that's the case, though, surely she would have told you why she's suggesting that course of treatment.
This may be what she has in mind: We have found that Cipro will actually stop a flare, with MC, virtually 100 % of the time, so maybe it will also stop a flare with Crohn's. That could be the reason why she is prescribing the Cipro. Since that could possibly open the door to a risk of C. diff, she may be prescribing the Flagyl, to preempt that possibility.
The problem with this plan is that a few days, (or a week or so), after stopping the Cipro, the symptoms will return, and you can't keep taking Cipro for long-term use, because of various reasons, not the least of which is a risk of tearing your Achilles tendons, (or tendons at other locations in the body).
Prednisone, (and budesonide), will not affect C. diff, so if you are symptom free, (no diarrhea), then you do not have C. diff. If, however, you do go ahead with the antibiotic treatment, I would advise that you begin taking a good probiotic, starting just before the antibiotic treatment ends, and continuing for at least a couple of weeks or so, in order to help prevent any stray C. diff bacteria from recolonizing your gut, which will be very vulnerable, just after the the antibiotic treatment ends. I'm no doctor, though, so all I can offer is my personal opinion, based on our experiences here.
Like you, I'm puzzled as to why she wants you to take the antibiotics, but maybe she has information about a possible infection that we're not aware of.
Tex
I agree with Tex....there is a long list of antibiotics that can lead to c-diff and I think Tex covered them. I did not want to take any more antibiotics than i really need to either and so i questioned that idea. You might want to clarify with her exactly what the purpose for each of these drugs might be.....and yes with the probiotics....i began taking them in between the vancomycin in hopes that some would survive...figured it is worth the try! keep us posted!
"It is very difficult to get a man to understand something, when his salary depends upon his not understanding it. "
Upton Sinclair
Upton Sinclair
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brboatwright
- Posts: 5
- Joined: Wed Apr 16, 2008 9:47 am
Antibiotics
My doctor prescribed the cipro and the flagyl because she said that is would help with the crohn's inflammation. She feels that the antibiotics will give me that extra boost to kick me into remissions because she has seen them work for severe inflammation in crohns. I have just never heard of that but remember that towards the end of last year when I first diagnosed, I was on flagyl, levoquin and at one point augmenten. The augmentin made me really sick so I get nervous about antibitics. So I think she believes that they work well for crohns inflammation and will give me that extra something to get the inflammation down enough that when I am completely back on entocort I can remain in remission. The other ? that I have, is the entocort. She has said that if she can get me into remission with the entocort, that I can stay on it forever as maintenance drug ( 2 tablets a day). Everything I read suggests differently. Has anyone heard of this either?
32 YR OLD/ DAYTON, OH - Crohns only in terminal Ileum - Diagnosed 10/2008
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brboatwright
- Posts: 5
- Joined: Wed Apr 16, 2008 9:47 am
My GI doctor stated that she was prescribing the flagyl and the cipro because it would help with the crohns inflammation. Her hope is that since everything else looks good with the exception of the inflammation, that the antibiotics will give me the extra push into clearing up the inflammation and kicking me into remission while transitioning back onto the entocort. ??????
My other ? is that she told me that if I go into remission and the entocort works this time after the prednisone, that I could stay on entocort as a maintenance drug. Everything that I read suggest that this is not the case. She said that it has been approved as a maintenance drug 2 pills once daily forever (or as long as it is working). Has anyone else heard this?
If the entocort does not work, she is going to start me on 6MP? What are 6MPs? Should that concern me?
My other ? is that she told me that if I go into remission and the entocort works this time after the prednisone, that I could stay on entocort as a maintenance drug. Everything that I read suggest that this is not the case. She said that it has been approved as a maintenance drug 2 pills once daily forever (or as long as it is working). Has anyone else heard this?
If the entocort does not work, she is going to start me on 6MP? What are 6MPs? Should that concern me?
32 YR OLD/ DAYTON, OH - Crohns only in terminal Ileum - Diagnosed 10/2008
Bethany,
Yes, that antibiotic combination is indeed an "approved" treatment method for Crohn's, when used the way you describe. Here's a reference on that, from the Crohn's and Colitis Foundation of America, if you want to read more about it:
http://www.ccfa.org/printview?pageUrl=/ ... ntibiotics
Notice the statement in the article about Cipro being far safer than Flagyl, (metronidazole).
Yes, Entocort has been approved for long-term use with Crohn's, however, I can't find any trials where it has been shown to be effective in preventing a Crohn's flare for more than about 12 months, so I suppose that's why your doctor added the disclaimer, (or as long as it is working). Here's a reference on that:
http://www.blackwell-synergy.com/doi/ab ... 05.41992.x
6-MP has been used for Crohn's for a long time, (as you can see from this article in the New England Journal of Medicine, published in 1980):
http://content.nejm.org/cgi/content/abstract/302/18/981
6-MP is actually a metabolite of azathioprine, so either one can be used, and both are immune system suppressants. Most immune system suppressants were originally developed to help prevent the body from rejecting organs following organ transplants, but most of them have subsequently been found to be useful in treating Crohn's, and other autoimmune diseases. One of the advantages of these two meds, is that they also help to control pain. Azathioprine and/or 6-MP are slow to take control, but they are pretty effective meds, in most cases. Here's some information on these two meds:
http://www.crohnsdiseasefocus.com/artic ... ession.php
Methotrexate is another immune system suppressant, but the newest drugs in that category that are beginning to be used more frequently for Crohn's are Humira, Remicade, and similar drugs, that are widely used to treat rheumatoid arthritis, and other autoimmune diseases.
All of the immune suppressants are very powerful drugs, with far-reaching effects, and are not to be taken lightly.
Tex
Yes, that antibiotic combination is indeed an "approved" treatment method for Crohn's, when used the way you describe. Here's a reference on that, from the Crohn's and Colitis Foundation of America, if you want to read more about it:
http://www.ccfa.org/printview?pageUrl=/ ... ntibiotics
Notice the statement in the article about Cipro being far safer than Flagyl, (metronidazole).
Yes, Entocort has been approved for long-term use with Crohn's, however, I can't find any trials where it has been shown to be effective in preventing a Crohn's flare for more than about 12 months, so I suppose that's why your doctor added the disclaimer, (or as long as it is working). Here's a reference on that:
http://www.blackwell-synergy.com/doi/ab ... 05.41992.x
6-MP has been used for Crohn's for a long time, (as you can see from this article in the New England Journal of Medicine, published in 1980):
http://content.nejm.org/cgi/content/abstract/302/18/981
6-MP is actually a metabolite of azathioprine, so either one can be used, and both are immune system suppressants. Most immune system suppressants were originally developed to help prevent the body from rejecting organs following organ transplants, but most of them have subsequently been found to be useful in treating Crohn's, and other autoimmune diseases. One of the advantages of these two meds, is that they also help to control pain. Azathioprine and/or 6-MP are slow to take control, but they are pretty effective meds, in most cases. Here's some information on these two meds:
http://www.crohnsdiseasefocus.com/artic ... ession.php
Methotrexate is another immune system suppressant, but the newest drugs in that category that are beginning to be used more frequently for Crohn's are Humira, Remicade, and similar drugs, that are widely used to treat rheumatoid arthritis, and other autoimmune diseases.
All of the immune suppressants are very powerful drugs, with far-reaching effects, and are not to be taken lightly.
Tex
WOW! Tex...you are amazing! What a helpful answer for Bethany....and the rest of us. I am always amazed at the info one get get on this board.Sounds like her doc may know what she is doing here!
"It is very difficult to get a man to understand something, when his salary depends upon his not understanding it. "
Upton Sinclair
Upton Sinclair
Well, I'm not to convinced of medically "approved" methods for MC, let alone the one for Crohns. Of all the various research into IBD, I've yet to see antibiotics/immune-suppressants/antiinflamitories bring about a cure. Perhaps some remission, but you'd need to take it for a long time. And if you did it might bring about other problems when it ends.
About the only convincing (to me) research as to really helping IBD involves Probiotics, Naltrexone, and some antibiotics, but I don't remember the ones you mentioned being the ones that helped the most. Though I didn't ever really research Crohns directly, a lot of the research I've gone through for IBDs, MC, IBS, MAPS (the bacteria some believe is involved in Crohns) lead me to what I've said.
Regardless, this is my opinion, but I'd recommend researching more or getting a second opinion.
Mike
About the only convincing (to me) research as to really helping IBD involves Probiotics, Naltrexone, and some antibiotics, but I don't remember the ones you mentioned being the ones that helped the most. Though I didn't ever really research Crohns directly, a lot of the research I've gone through for IBDs, MC, IBS, MAPS (the bacteria some believe is involved in Crohns) lead me to what I've said.
Regardless, this is my opinion, but I'd recommend researching more or getting a second opinion.
Mike