What antibiotic is used to treat c diff. Effective Antibiotics for Treating C. difficile Infection: A Comprehensive Guide
What are the most effective antibiotics for treating C. difficile infection. How do different antibiotics impact the gut microbiome during C. difficile treatment. What are the potential side effects and risks associated with antibiotic treatment for C. difficile. How can recurrence of C. difficile infection be prevented after antibiotic treatment.
Understanding C. difficile Infection and Its Causes
Clostridium difficile, commonly known as C. diff, is a bacterium that can cause severe gastrointestinal infections. These infections often occur after the use of antibiotics, which disrupt the normal balance of gut bacteria. This disruption allows C. diff to flourish and produce toxins that damage the intestinal lining.
Why does antibiotic use increase the risk of C. diff infection? Antibiotics eliminate both harmful and beneficial bacteria in the gut. This reduction in microbial diversity creates an environment where opportunistic pathogens like C. diff can thrive. A study by Theriot et al. (2014) demonstrated that antibiotic-induced shifts in the mouse gut microbiome increased susceptibility to C. difficile infection.
Risk Factors for C. difficile Infection
- Recent antibiotic use
- Prolonged hospital stays
- Advanced age (65 years or older)
- Weakened immune system
- Previous C. diff infection
First-Line Antibiotic Treatments for C. difficile Infection
When it comes to treating C. difficile infections, healthcare providers typically turn to specific antibiotics that target this particular bacterium. The choice of antibiotic depends on the severity of the infection and whether it’s a first occurrence or a recurrence.
Vancomycin: A Powerful Option for Severe Cases
Vancomycin is often considered the gold standard for treating severe C. difficile infections. It works by inhibiting cell wall synthesis in bacteria, effectively killing C. diff. A study by Stevens et al. (2017) found that vancomycin was more effective than metronidazole in preventing recurrence and death in patients with C. difficile infection.
Metronidazole: Effective for Mild to Moderate Cases
For mild to moderate cases of C. diff infection, metronidazole is often the first choice. It’s generally less expensive than vancomycin and has been shown to be effective in many cases. However, its use has declined in recent years due to increasing resistance and the availability of more targeted treatments.
Fidaxomicin: A Newer Option with Promising Results
Fidaxomicin is a newer antibiotic specifically developed to treat C. difficile infections. It has shown promising results in clinical trials, particularly in reducing the risk of recurrence. A study by Cornely et al. (2012) demonstrated that fidaxomicin was non-inferior to vancomycin in treating C. diff infections and was associated with lower recurrence rates.
The Impact of Antibiotics on Gut Microbiome During C. difficile Treatment
While antibiotics are essential for treating C. difficile infections, they can have significant impacts on the overall gut microbiome. Understanding these effects is crucial for developing more targeted and effective treatments.
How do different antibiotics affect the gut microbiome? Vancomycin, metronidazole, and fidaxomicin each have distinct effects on the bacterial and fungal communities in the gut. A study by Antharam et al. (2013) found that C. difficile infection and its treatment were associated with intestinal dysbiosis and depletion of beneficial bacteria, particularly those that produce butyrate, an important short-chain fatty acid for gut health.
Comparing Microbiome Effects of Different Antibiotics
- Vancomycin: Broad-spectrum activity, significant impact on gut microbiome diversity
- Metronidazole: Narrower spectrum, less impact on overall microbiome diversity
- Fidaxomicin: Most targeted approach, minimal disruption to the normal gut flora
Strategies for Preventing C. difficile Recurrence After Antibiotic Treatment
Preventing recurrence is a crucial aspect of C. difficile treatment. Recurrent infections can be more difficult to treat and may lead to severe complications. Several strategies have been developed to reduce the risk of recurrence after initial antibiotic treatment.
Can probiotics help prevent C. difficile recurrence? While the evidence is mixed, some studies suggest that certain probiotic strains may help restore a healthy gut microbiome and reduce the risk of C. diff recurrence. However, more research is needed to establish definitive guidelines for probiotic use in this context.
Promising Approaches for Recurrence Prevention
- Extended or pulsed antibiotic regimens
- Fecal microbiota transplantation (FMT)
- Targeted microbiome restoration therapies
- Immunization against C. difficile toxins
- Lifestyle modifications to support gut health
Emerging Therapies and Future Directions in C. difficile Treatment
The field of C. difficile treatment is rapidly evolving, with new therapies and approaches being developed to address the limitations of current treatments. These innovative strategies aim to provide more targeted and effective solutions while minimizing disruption to the gut microbiome.
What are some promising new therapies for C. difficile infection? Several novel approaches are currently in development or undergoing clinical trials:
- Monoclonal antibodies targeting C. difficile toxins
- Engineered bacteriophages to selectively target C. diff
- Microbiome-based therapies to restore gut health
- Novel antibiotics with enhanced specificity for C. difficile
The Role of Non-Antibiotic Approaches in C. difficile Management
While antibiotics remain the primary treatment for C. difficile infections, there is growing interest in non-antibiotic approaches to manage and prevent these infections. These strategies focus on strengthening the body’s natural defenses and creating an environment inhospitable to C. diff.
How can the gut environment be modified to resist C. difficile colonization? Several approaches have shown promise:
Innovative Non-Antibiotic Strategies
- Bile acid modulation: Thanissery et al. (2017) demonstrated that secondary bile acids produced by gut bacteria can inhibit C. difficile spore germination and growth.
- Dietary interventions: Modifying diet to promote the growth of beneficial bacteria and inhibit C. diff.
- Immune system modulation: Enhancing the body’s natural defenses against C. difficile.
- Competitive exclusion: Introducing non-toxigenic C. difficile strains to outcompete pathogenic strains (Zhang et al., 2015).
Understanding C. difficile Virulence Factors and Their Implications for Treatment
To develop more effective treatments for C. difficile infections, it’s crucial to understand the virulence factors that contribute to the bacterium’s pathogenicity. These factors enable C. diff to colonize the gut, evade the immune system, and cause damage to the intestinal lining.
What are the key virulence factors of C. difficile? Several components contribute to its ability to cause infection:
C. difficile Virulence Factors
- Toxins A and B: Primary contributors to intestinal damage and inflammation
- Binary toxin (CDT): Present in some strains, may increase severity of infection
- Surface layer proteins: Aid in adhesion to intestinal cells (Spigaglia et al., 2013)
- Collagen-binding protein A (CbpA): Facilitates attachment to host tissues (Tulli et al., 2013)
- Fibronectin-binding protein A: Plays a role in intestinal colonization (Barketi-Klai et al., 2011)
Understanding these virulence factors can lead to the development of targeted therapies that specifically disrupt C. difficile’s ability to cause infection without broadly impacting the gut microbiome.
Optimizing Antibiotic Treatment Regimens for C. difficile Infection
While the choice of antibiotic is crucial in treating C. difficile infections, the optimal dosing and duration of treatment are equally important. Researchers and clinicians continue to refine treatment regimens to maximize efficacy while minimizing the risk of recurrence and adverse effects.
How can antibiotic treatment for C. difficile be optimized? Several strategies have been explored:
Innovative Treatment Approaches
- Extended-pulsed fidaxomicin regimens: Shown to reduce recurrence rates compared to standard treatment
- Combination therapy: Bass et al. (2013) investigated the use of vancomycin in combination with other antibiotics for severe C. diff infections
- Tapered and pulsed vancomycin regimens: May help prevent recurrence in some patients
- Consideration of concomitant antibiotics: Mullane et al. (2011) found that fidaxomicin was effective even in patients taking other antibiotics for concurrent infections
The postantibiotic effect of antibiotics is also an important consideration. Babakhani et al. (2011) demonstrated that fidaxomicin and its major metabolite exhibit a prolonged postantibiotic effect against C. difficile, which may contribute to its efficacy in preventing recurrence.
As research in this field continues to advance, treatment protocols will likely become more personalized, taking into account factors such as infection severity, patient risk factors, and the specific strain of C. difficile involved. This tailored approach holds promise for improving outcomes and reducing the burden of C. difficile infections in healthcare settings and the community.
Antibiotic Treatments for Clostridium difficile Infection Are Associated with Distinct Bacterial and Fungal Community Structures
1. Theriot CM, Koenigsknecht MJ, Carlson PE, Hatton GE, Nelson AM, Li B, Huffnagle GB, Z Li J, Young VB.
2014.
Antibiotic-induced shifts in the mouse gut microbiome and metabolome increase susceptibility to Clostridium difficile infection. Nat Commun
5:3114. doi: 10.1038/ncomms4114. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
2. Stevens V, Dumyati G, Fine LS, Fisher SG, van Wijngaarden E.
2011.
Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. Clin Infect Dis
53:42–48. doi: 10.1093/cid/cir301. [PubMed] [CrossRef] [Google Scholar]
3. Antharam VC, Li EC, Ishmael A, Sharma A, Mai V, Rand KH, Wang GP.
2013.
Intestinal dysbiosis and depletion of butyrogenic bacteria in Clostridium difficile infection and nosocomial diarrhea. J Clin Microbiol
51:2884–2892. doi: 10.1128/JCM.00845-13. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
4. Seekatz AM, Young VB.
2014.
Clostridium difficile and the microbiota. J Clin Invest
124:4182–4189. doi: 10.1172/JCI72336. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
5. Thanissery R, Winston JA, Theriot CM.
2017.
Inhibition of spore germination, growth, and toxin activity of clinically relevant C. difficile strains by gut microbiota derived secondary bile acids. Anaerobe
45:86–100. doi: 10.1016/j.anaerobe.2017.03.004. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
6. Bhattacharjee D, Francis MB, Ding X, McAllister KN, Shrestha R, Sorg JA.
2015.
Reexamining the germination phenotypes of several Clostridium difficile strains suggests another role for the CspC germinant receptor. J Bacteriol
198:777–786. doi: 10.1128/JB.00908-15. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
7. Zhang K, Zhao S, Wang Y, Zhu X, Shen H, Chen Y, Sun X.
2015.
The non-toxigenic Clostridium difficile CD37 protects mice against infection with a BI/NAP1/027 type of C. difficile strain. Anaerobe
36:49–52. doi: 10.1016/j.anaerobe.2015.09.009. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
8. Tulli L, Marchi S, Petracca R, Shaw HA, Fairweather NF, Scarselli M, Soriani M, Leuzzi R.
2013.
CbpA: a novel surface exposed adhesin of Clostridium difficile targeting human collagen. Cell Microbiol
15:1674–1687. doi: 10.1111/cmi.12139. [PubMed] [CrossRef] [Google Scholar]
9. Barketi-Klai A, Hoys S, Lambert-Bordes S, Collignon A, Kansau I.
2011.
Role of fibronectin-binding protein A in Clostridium difficile intestinal colonization. J Med Microbiol
60:1155–1161. doi: 10.1099/jmm.0.029553-0. [PubMed] [CrossRef] [Google Scholar]
10. Spigaglia P, Barketi-Klai A, Collignon A, Mastrantonio P, Barbanti F, Rupnik M, Janezic S, Kansau I.
2013.
Surface-layer (S-layer) of human and animal Clostridium difficile strains and their behaviour in adherence to epithelial cells and intestinal colonization. J Med Microbiol
62:1386–1393. doi: 10.1099/jmm. 0.056556-0. [PubMed] [CrossRef] [Google Scholar]
11. Stevens VW, Nelson RE, Schwab-Daugherty EM, Khader K, Jones MM, Brown KA, Greene T, Croft LD, Neuhauser M, Glassman P, Goetz MB, Samore MH, Rubin MA.
2017.
Comparative effectiveness of vancomycin and metronidazole for the prevention of recurrence and death in patients with Clostridium difficile infection. JAMA Intern Med
177:546–553. doi: 10.1001/jamainternmed.2016.9045. [PubMed] [CrossRef] [Google Scholar]
12. Bass SN, Bauer SR, Neuner EA, Lam SW.
2013.
Comparison of treatment outcomes with vancomycin alone versus combination therapy in severe Clostridium difficile infection. J Hosp Infect
85:22–27. doi: 10.1016/j.jhin.2012.12.019. [PubMed] [CrossRef] [Google Scholar]
13. Cornely OA, Crook DW, Esposito R, Poirier A, Somero MS, Weiss K, Sears P, Gorbach S, OPT-80-004 Clinical Study Group. 2012.
Fidaxomicin versus vancomycin for infection with Clostridium difficile in Europe, Canada, and the USA: a double-blind, non-inferiority, randomised controlled trial. Lancet Infect Dis
12:281–289. doi: 10.1016/S1473-3099(11)70374-7. [PubMed] [CrossRef] [Google Scholar]
14. Babakhani F, Gomez A, Robert N, Sears P.
2011.
Postantibiotic effect of fidaxomicin and its major metabolite, OP-1118, against Clostridium difficile. Antimicrob Agents Chemother
55:4427–4429. doi: 10.1128/AAC.00104-11. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
15. Mullane KM, Miller MA, Weiss K, Lentnek A, Golan Y, Sears PS, Shue YK, Louie TJ, Gorbach SL.
2011.
Efficacy of fidaxomicin versus vancomycin as therapy for Clostridium difficile infection in individuals taking concomitant antibiotics for other concurrent infections. Clin Infect Dis
53:440–447. doi: 10.1093/cid/cir404. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
16. Sangster W, Hegarty JP, Schieffer KM, Wright JR, Hackman J, Toole DR, Lamendella R, Stewart DB Sr.
2016.
Bacterial and fungal microbiota changes distinguish C. difficile infection from other forms of diarrhea: results of a prospective inpatient study. Front Microbiol
7:789. doi: 10.3389/fmicb.2016.00789. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
17. Said HS, Suda W, Nakagome S, Chinen H, Oshima K, Kim S, Kimura R, Iraha A, Ishida H, Fujita J, Mano S, Morita H, Dohi T, Oota H, Hattori M.
2014.
Dysbiosis of salivary microbiota in inflammatory bowel disease and its association with oral immunological biomarkers. DNA Res
21:15–25. doi: 10.1093/dnares/dst037. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
18. Whitman CB, Czosnowski QA.
2012.
Fidaxomicin for the treatment of Clostridium difficile infections. Ann Pharmacother
46:219–228. doi: 10.1345/aph.1Q481. [PubMed] [CrossRef] [Google Scholar]
19. Biedenbach DJ, Ross JE, Putnam SD, Jones RN.
2010.
In vitro activity of fidaxomicin (OPT-80) tested against contemporary clinical isolates of Staphylococcus spp. and Enterococcus spp. Antimicrob Agents Chemother
54:2273–2275. doi: 10.1128/AAC.00090-10. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
20. Louie TJ, Emery J, Krulicki W, Byrne B, Mah M.
2009.
OPT-80 eliminates Clostridium difficile and is sparing of Bacteroides species during treatment of C. difficile infection. Antimicrob Agents Chemother
53:261–263. doi: 10.1128/AAC.01443-07. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
21. Louie TJ, Miller MA, Mullane KM, Weiss K, Lentnek A, Golan Y, Gorbach S, Sears P, Shue YK, OPT-80-003 Clinical Study Group. 2011.
Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med
364:422–431. doi: 10.1056/NEJMoa0910812. [PubMed] [CrossRef] [Google Scholar]
22. Watt M, Dinh A, Le Monnier A, Tilleul P.
2017.
Cost-effectiveness analysis on the use of fidaxomicin and vancomycin to treat Clostridium difficile infection in France. J Med Econ
20:678–686. doi: 10.1080/13696998.2017.1302946. [PubMed] [CrossRef] [Google Scholar]
23. Babakhani F, Seddon J, Sears P.
2014.
Comparative microbiological studies of transcription inhibitors fidaxomicin and the rifamycins in Clostridium difficile. Antimicrob Agents Chemother
58:2934–2937. doi: 10.1128/AAC.02572-13. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
24. Louie TJ, Cannon K, Byrne B, Emery J, Ward L, Eyben M, Krulicki W.
2012.
Fidaxomicin preserves the intestinal microbiome during and after treatment of Clostridium difficile infection (CDI) and reduces both toxin reexpression and recurrence of CDI. Clin Infect Dis
55:S132–S142. doi: 10.1093/cid/cis338. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
25. Elsing C, Ernst S, Kayali N, Stremmel W, Harenberg S.
2011.
Lipopolysaccharide binding protein, interleukin-6 and C-reactive protein in acute gastrointestinal infections: value as biomarkers to reduce unnecessary antibiotic therapy. Infection
39:327–331. doi: 10.1007/s15010-011-0117-5. [PubMed] [CrossRef] [Google Scholar]
26. Burakoff R, Zhao L, Celifarco AJ, Rose KL, Donovan V, Pothoulakis C, Percy WH.
1995.
Effects of purified Clostridium difficile toxin A on rabbit distal colon. Gastroenterology
109:348–354. doi: 10.1016/0016-5085(95)90320-8. [PubMed] [CrossRef] [Google Scholar]
27. Shoshan MC, Florin I, Thelestam M.
1993.
Activation of cellular phospholipase A2 by Clostridium difficile toxin B. J Cell Biochem
52:116–124. doi: 10.1002/jcb.240520115. [PubMed] [CrossRef] [Google Scholar]
28. Zanella Terrier MC, Simonet ML, Bichard P, Frossard JL.
2014.
Recurrent Clostridium difficile infections: the importance of the intestinal microbiota. World J Gastroenterol
20:7416–7423. doi: 10.3748/wjg.v20.i23.7416. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
29. Koropatkin NM, Cameron EA, Martens EC.
2012.
How glycan metabolism shapes the human gut microbiota. Nat Rev Microbiol
10:323–335. doi: 10.1038/nrmicro2746. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
30. Ng KM, Ferreyra JA, Higginbottom SK, Lynch JB, Kashyap PC, Gopinath S, Naidu N, Choudhury B, Weimer BC, Monack DM, Sonnenburg JL.
2013.
Microbiota-liberated host sugars facilitate post-antibiotic expansion of enteric pathogens. Nature
502:96–99. doi: 10.1038/nature12503. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
31. Galán A, Moreno L, Párraga J, Serrano Á, Sanz MJ, Cortes D, Cabedo N.
2013.
Novel isoquinoline derivatives as antimicrobial agents. Bioorg Med Chem
21:3221–3230. doi: 10.1016/j.bmc.2013.03.042. [PubMed] [CrossRef] [Google Scholar]
32. Ma YM, Qiao K, Kong Y, Li MY, Guo LX, Miao Z, Fan C.
2017.
A new isoquinolone alkaloid from an endophytic fungus R22 of Nerium indicum. Nat Prod Res
31:951–958. doi: 10.1080/14786419.2016.1258556. [PubMed] [CrossRef] [Google Scholar]
33. Langille MG, Zaneveld J, Caporaso JG, McDonald D, Knights D, Reyes JA, Clemente JC, Burkepile DE, Vega Thurber RL, Knight R, Beiko RG, Huttenhower C.
2013.
Predictive functional profiling of microbial communities using 16S rRNA marker gene sequences. Nat Biotechnol
31:814–821. doi: 10.1038/nbt.2676. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
34. Barberán A, Caceres Velazquez H, Jones S, Fierer N.
2017.
Hiding in plain sight: mining bacterial species records for phenotypic trait information. mSphere
2:e00237-17. doi: 10.1128/mSphere.00237-17
pii:e00237-17. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
35. van Leeuwen PT, van der Peet JM, Bikker FJ, Hoogenkamp MA, Oliveira Paiva AM, Kostidis S, Mayboroda OA, Smits WK, Krom BP.
2016.
Interspecies interactions between Clostridium difficile and Candida albicans. mSphere
1:e00187-17. doi: 10.1128/mSphere.00187-16. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
36. Jawhara S, Thuru X, Standaert-Vitse A, Jouault T, Mordon S, Sendid B, Desreumaux P, Poulain D.
2008.
Colonization of mice by Candida albicans is promoted by chemically induced colitis and augments inflammatory responses through galectin-3. J Infect Dis
197:972–980. doi: 10.1086/528990. [PubMed] [CrossRef] [Google Scholar]
37. Goldstein EJC, Johnson SJ, Maziade PJ, Evans CT, Sniffen JC, Millette M, McFarland LV.
2017.
Probiotics and prevention of Clostridium difficile infection. Anaerobe
45:114–119. doi: 10.1016/j.anaerobe.2016.12.007. [PubMed] [CrossRef] [Google Scholar]
38. Tung JM, Dolovich LR, Lee CH.
2009.
Prevention of Clostridium difficile infection with Saccharomyces boulardii: a systematic review. Can J Gastroenterol
23:817–821. doi: 10.1155/2009/915847. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
39. Newton DF, Macfarlane S, Macfarlane GT.
2013.
Effects of antibiotics on bacterial species composition and metabolic activities in chemostats containing defined populations of human gut microorganisms. Antimicrob Agents Chemother
57:2016–2025. doi: 10.1128/AAC.00079-13. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
40. Zhai H, Pan J, Pang E, Bai B.
2014.
Lavage with allicin in combination with vancomycin inhibits biofilm formation by Staphylococcus epidermidis in a rabbit model of prosthetic joint infection. PLoS One
9:e102760. doi: 10.1371/journal. pone.0102760. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
41. Goldstein EJ, Babakhani F, Citron DM.
2012.
Antimicrobial activities of fidaxomicin. Clin Infect Dis
55(Suppl 2):S143–S148. doi: 10.1093/cid/cis339. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
42. Rognes T, Flouri T, Nichols B, Quince C, Mahé F.
2016.
VSEARCH: a versatile open source tool for metagenomics. PeerJ
4:e2584. doi: 10.7717/peerj.2584. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
43. Edgar RC.
2010.
Search and clustering orders of magnitude faster than BLAST. Bioinformatics
26:2460–2461. doi: 10.1093/bioinformatics/btq461. [PubMed] [CrossRef] [Google Scholar]
44. Caporaso JG, Kuczynski J, Stombaugh J, Bittinger K, Bushman FD, Costello EK, Fierer N, Peña AG, Goodrich JK, Gordon JI, Huttley GA, Kelley ST, Knights D, Koenig JE, Ley RE, Lozupone CA, McDonald D, Muegge BD, Pirrung M, Reeder J, Sevinsky JR, Turnbaugh PJ, Walters WA, Widmann J, Yatsunenko T, Zaneveld J, Knight R.
2010.
QIIME allows analysis of high-throughput community sequencing data. Nat Methods
7:335–336. doi: 10.1038/nmeth.f.303. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
45. DeSantis TZ, Hugenholtz P, Larsen N, Rojas M, Brodie EL, Keller K, Huber T, Dalevi D, Hu P, Andersen GL.
2006.
Greengenes, a chimera-checked 16S rRNA gene database and workbench compatible with ARB. Appl Environ Microbiol
72:5069–5072. doi: 10.1128/AEM.03006-05. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
46. Paulson JN, Stine OC, Bravo HC, Pop M.
2013.
Differential abundance analysis for microbial marker-gene surveys. Nat Methods
10:1200–1202. doi: 10.1038/nmeth.2658. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
47. Paulson JN, Pop M, Bravo HC.
2013.
metagenomeSeq: statistical analysis for sparse high-throughput sequencing. Bioconductor package
1.11.10 ed.
https://bioconductor.org/packages/release/bioc/html/metagenomeSeq.html.
48. Segata N, Izard J, Waldron L, Gevers D, Miropolsky L, Garrett WS, Huttenhower C.
2011.
Metagenomic biomarker discovery and explanation. Genome Biol
12:R60. doi: 10.1186/gb-2011-12-6-r60. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
49. Smith DP, Peay KG.
2014.
Sequence depth, not PCR replication, improves ecological inference from next generation DNA sequencing. PLoS One
9:e90234. doi: 10.1371/journal.pone.0090234. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
50. Bolger AM, Lohse M, Usadel B.
2014.
Trimmomatic: a flexible trimmer for Illumina sequence data. Bioinformatics
30:2114–2120. doi: 10.1093/bioinformatics/btu170. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
51. Kõljalg U, Nilsson RH, Abarenkov K, Tedersoo L, Taylor AF, Bahram M, Bates ST, Bruns TD, Bengtsson-Palme J, Callaghan TM, Douglas B, Drenkhan T, Eberhardt U, Dueñas M, Grebenc T, Griffith GW, Hartmann M, Kirk PM, Kohout P, Larsson E, Lindahl BD, Lücking R, Martín MP, Matheny PB, Nguyen NH, Niskanen T, Oja J, Peay KG, Peintner U, Peterson M, Põldmaa K, Saag L, Saar I, Schüßler A, Scott JA, Senés C, Smith ME, Suija A, Taylor DL, Telleria MT, Weiss M, Larsson KH.
2013.
Towards a unified paradigm for sequence-based identification of fungi. Mol Ecol
22:5271–5277. doi: 10.1111/mec.12481. [PubMed] [CrossRef] [Google Scholar]
52. Faust K, Sathirapongsasuti JF, Izard J, Segata N, Gevers D, Raes J, Huttenhower C.
2012.
Microbial co-occurrence relationships in the human microbiome. PLoS Comput Biol
8:e1002606. doi: 10.1371/journal.pcbi.1002606. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
53. Walters W, Hyde ER, Berg-Lyons D, Ackermann G, Humphrey G, Parada A, Gilbert JA, Jansson JK, Caporaso JG, Fuhrman JA, Apprill A, Knight R.
2015.
Improved bacterial 16S rRNA gene (V4 and V4-5) and fungal internal transcribed spacer marker gene primers for microbial community surveys. mSystems
1:e00009-15. doi: 10.1128/mSystems.00009-15. [PMC free article] [PubMed] [CrossRef] [Google Scholar]
What you need to know about Clostridium difficile
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According to the Centers for Disease Control and Prevention (CDC), Each year, more than 2 million people in the United States get infections from germs that are resistant to antibiotics– and at least 23,000 people die as a result. C. difficile infections—which can occur after using antibiotics—kill at least another 15,000 Americans a year.
What is Clostridium difficile (or C. diff) infection?
Your body has a lot of “good” and necessary bacteria. It also has some “bad” or dangerous bacteria. Clostridium difficile (C. diff) is part of the normal bacteria found in some people’s intestines or colons. Fortunately, when you are healthy and are not taking antibiotics, the millions of good bacteria in your system keep the C. diff under control and in smaller numbers. However, when you take an antibiotic, the levels of good bacteria are reduced down to a smaller number. This makes it possible for the C. diff to overpopulate your intestine or colon. When this happens, you may get the illness called Clostridium difficile colitis.
C. diff produces spores when attacked by antibiotics. The spores can live in the open air or in dirt for up to two years. Normal disinfectants are not effective against the spores. This means that even if you kill the C. diff bacteria, spores can still be present. This is why you can get rid of the C. diff symptoms when being treated with medicine, but it can come back later.
What are the symptoms of C. diff infection?
When you have an imbalance of bacteria and C. diff takes over, it creates two main types of toxins that affect your body and give you the symptoms of the actual disease. The toxins attack your intestinal wall and, when left untreated, may cause an ulcer or sore. The symptoms are similar to severe food poisoning. At first, your symptoms may include diarrhea and cramping. The later stages are flu-like symptoms, including weakness, dehydration, fever, nausea, vomiting, and—in advanced stages—blood in your stool/feces. If a patient is left untreated, he/she can die from it. C. diff is linked to 14,000 deaths in America each year.
How is C. diff diagnosed?
First, you must have some symptoms listed above. You must see your doctor to be diagnosed and treated. A special test is needed to officially determine whether or not you have C. diff; this requires the lab to test a sample of your stool. If a diagnosis of C. diff is made, a gastroenterologist, a doctor who is trained to deal with illnesses of the gastrointestinal tract (stomach and intestines), will most likely help treat your C. diff. The gastroenterologist may perform a colonoscopy to assess the damage to your intestines and the presence of the C. diff and polyps (a fleshy growth on the inside of the colon).
Some regular physicians can treat and cure you. If you have a stubborn case of C. diff, you may ask your physician to refer you to a specialist. There have been cases where non-specialist physicians did not know enough about C. diff and actually aggravated the condition by misdiagnosing or prescribing another antibiotic or medicine that encouraged C. diff overpopulation.
Who is at risk for C. diff infections?
Although people, including children, with no known risk factors have acquired C. diff infection, the following groups of people are at greatest risk:
- Those who are now taking or have recently taken antibiotics. The risk goes up if you take broad-spectrum drugs that target a wide range of bacteria, use multiple antibiotics, or take antibiotics for a long period of time.
- Adults who are 65 years of age or older. The risk of becoming infected with C. diff is 10 times greater for people age 65 and older than it is with younger people.
- Those who are now or have recently been hospitalized, especially for an extended period.
- Those who live in a nursing home or long-term care facility.
- Those who have a serious underlying illness or a weakened immune system as a result of a medical condition or treatment (such as chemotherapy).
- Those who have had abdominal surgery or a gastrointestinal procedure.
- Those who have a colon disease such as inflammatory bowel disease or colorectal cancer.
- Those who have had a previous C. diff infection.
How is C. diff treated?
Antibiotics are usually the cause of recurrent cases of C. diff. Ironically, two very powerful antibiotics are used to treat the disease! The most common and least expensive drug used is Flagyl (metronidazole). If Flagyl is ineffective, then Vancocin (vancomycin) is prescribed.
In rare cases, C. diff may not respond well to antibiotics, with infections persisting for months and even years. New studies have shed light on a treatment that was once considered a last resort by many doctors. The treatment is called fecal bacteriotherapy; this means that someone else’s “healthy” stool is transplanted inside of the C. diff patient. The new study shows that donor stool transplantation effectively cured 90 percent of patients’ recurrent C. diff infections. Transplanting donor stool is effective because it replaces the good bowel flora that was killed off by the use of antibiotics and naturally combats the invasive bacterium.
How can C. diff be prevented?
Hospitals and other healthcare facilities follow strict infection-control guidelines to prevent C. diff. If you have a friend or family member in a hospital or nursing home, don’t be afraid to remind caregivers to follow the recommended precautions.
- Hand washing. Healthcare providers should practice good hand hygiene with soap and warm water or alcohol-based hand rubs before and after treating each person in their care. Visitors also should be diligent about hand hygiene before and after leaving the room or using the bathroom and should not use the patient’s sink or bathroom. Patients need to practice good hand hygiene as well.
- Contact precautions. People who are hospitalized with C. diff have a private room or share a room with someone who has the same illness. Hospital staff and visitors should wear disposable gloves and gowns while in the room.
- Careful cleaning. In any setting, all surfaces should be carefully disinfected with a product that contains chlorine bleach. C. diff spores cannot survive routine cleaning products that contain bleach.
- Appropriate use of antibiotics. Antibiotics are sometimes prescribed when they are not needed. Antibiotics will not cure viral illnesses, such as the common cold. Take a “wait-and-see” attitude with simple ailments. Remember: “Snort. Sniffle. Sneeze. No antibiotics, please!” If you do need an antibiotic, ask your doctor to prescribe one that has a narrow range and that you take for the shortest time possible.
Additional resources
APIC—The ABC’s of Antibiotics
The Centers for Disease Control and Prevention—Clostridium difficile infection
The Centers for Disease Control and Prevention—Get Smart: Know when antibiotics work
The Centers for Disease Control and Prevention—Vital Signs: Stopping Clostridium difficile infections
MedLine Plus—Clostridium difficile Infections
Antibiotics for the treatment of intestinal infection: which to take and when?
Contents
- 1 Which antibiotics are effective in treating intestinal infections: drug ratings and guidelines for use
- 1. 1 How does intestinal infection occur?
- 1.2 Symptoms of an intestinal infection
- 1.3 How to diagnose an intestinal infection?
- 1.3.1 Symptoms of an intestinal infection
- 1.3.2 Diagnostic methods
- 1.4 How to treat an intestinal infection without antibiotics?
- 1.5 It is important to know when to take antibiotics for intestinal infections
- 1.6 Which antibiotics can be taken for intestinal infections?
- 1.7 What is the correct way to take antibiotics for an intestinal infection?
- 1.7.1 Consult a doctor
- 1.7.2 Follow instructions
- 1.7.3 Take antibiotics correctly
- 1.7.4 Maintain good hygiene
- 1.7.5 Watch your diet
900 05 1.7.6 Do not overuse antibiotics
- 1.8 Side effects of antibiotics
- 1.9 How long should I take antibiotics for an intestinal infection?
- 1.10 What if antibiotics do not help with an intestinal infection?
- 1. 11 How to prevent intestinal infection?
- 1.11.1 1. Practice good hand hygiene
- 1.11.2 2. Handle food with care
- 1.11.3 3. Drink quality water
- 1.11.4 4. Stay home if you are sick
9 0017
- 1.12 Related videos:
- 1.13 Q&A:
- 1.13.0.1 What antibiotics are recommended for treating intestinal infections?
- 1.13.0.2 What dosage of antibiotics should be taken for an intestinal infection?
- 1.13.0.3 Can antibiotics cause side effects when treating an intestinal infection?
- 1.13.0.4 How long should antibiotics be taken to treat an intestinal infection?
- 1.13.0.5 What are the ways to prevent intestinal infection?
- 1.13.0.6 Can an intestinal infection be treated without antibiotics?
Find out which antibiotics help fight intestinal infections and how to take your medicines correctly to avoid complications. Reliable advice from experienced professionals in our article
Intestinal infection is a common cause of diseases of the gastrointestinal tract. It can be caused by various bacteria and viruses and presents with symptoms such as diarrhea, vomiting, abdominal pain and fever. Treatment for an intestinal infection may vary depending on the cause, but doctors often recommend antibiotics.
Antibiotics are medicines used to kill bacteria and prevent their further spread. However, not all antibiotics are suitable for treating intestinal infections and should not be taken without consulting a doctor. In this article, we’ll look at which antibiotics are used to treat intestinal infections and when to take them.
Important to remember: Never take antibiotics without consulting your doctor, even if you have symptoms of an intestinal infection. Misuse of antibiotics can worsen health conditions, cause complications, and lead to bacterial resistance to the drug.
How does an intestinal infection occur?
Intestinal infection is a disease of the digestive system caused by the introduction of pathogenic microorganisms into the human body. It can occur as a result of the consumption of poor quality products that are in unfavorable storage conditions, as well as as a result of contact with contaminated surfaces and objects.
The symptoms of an intestinal infection are varied and depend on the degree of damage to the body. They usually manifest as nausea, vomiting, abdominal pain, intestinal motility disorders, decreased appetite and body temperature.
It is important to consult a doctor at the first symptoms and consult about the need for antibiotics to treat an intestinal infection. Do not self-medicate, as medicines prescribed without supervision can negatively affect the body and aggravate the situation.
In addition to taking antibiotics to treat intestinal infections, it is important to practice good hygiene, wash your hands regularly, avoid questionable foods and contact with contaminated objects.
Symptoms of intestinal infection
Intestinal infection is a disease caused by microorganisms such as bacteria, viruses and parasites and can lead to several serious symptoms. Some of the most common symptoms of an intestinal infection include:
- Diarrhea: this is probably the most common symptom of an intestinal infection. The person often experiences loose stools,
- Nausea: which can lead to vomiting and loss of appetite,
- Animal pains: which may be spasms or stiffness,
- Headache: which may be associated with general symptoms such as weakness and fatigue,
- Weakness: in a general and complex condition.
If you notice these symptoms in yourself, you should immediately consult a doctor to get a diagnosis and appropriate treatment. Treatment for an intestinal infection may include antibiotics for the bacterial infection and other medications to help control symptoms and help you recover quickly.
How to diagnose an intestinal infection?
Symptoms of an intestinal infection
To diagnose an intestinal infection, look for the following symptoms:
- Frequent abdominal pain;
- Diarrhea;
- Nausea;
- Vomiting;
- Increased body temperature;
- Weakness and fatigue;
- Lack of appetite;
- Bloating.
If you experience these symptoms, see your doctor.
Diagnostic methods
The following methods are used to accurately diagnose intestinal infection:
- Analysis of feces for the presence of infectious agents;
- Blood tests that measure the degree of infection in the body;
- Diagnostic colonoscopy, which looks at the inside of the intestine.
After a thorough diagnosis, the doctor will prescribe treatment, including antibiotics and other medications, depending on the type and extent of the infection.
How to treat an intestinal infection without antibiotics?
Intestinal infection can be treated without the use of antibiotics. To do this, you must follow certain guidelines.
1. Drink plenty of water and fluids. With diarrhea, a person loses a lot of water and electrolytes, so it is very important to increase the amount of fluid you drink. You can supplement your diet with electrolyte oral solutions to help restore the body’s electrolyte balance.
2. Keep a diet. Avoid heavy and fatty foods, as well as dairy products and spices. You can eat light cereals, broths, fried meat and fish, green vegetables and fruits.
3. Take probiotics. Probiotics improve the condition of the intestinal flora and speed up the healing process. You can use special microorganisms that are found in yogurt, kefir, kvass or special additives.
4. Maintain good hygiene. Do not forget about hand hygiene before eating and after going to the toilet. This will help you avoid re-infection and spreading the disease to other people.
5. Avoid self-medication. Do not use antibiotics without consulting your doctor. Some drugs can worsen the condition and contribute to the development of complications.
It is important to know when to take antibiotics for intestinal infections
Antibiotics for intestinal infections should be taken only when prescribed by a doctor. It is necessary to diagnose and find out which type of bacteria caused the disease. Only then can you choose the most effective drug and determine the dosage.
Intestinal infections often cause diarrhea, so it is important to drink plenty of fluids to prevent dehydration. Antibiotics should be taken strictly in accordance with the doctor’s prescription, without changing the dosage and without interrupting the course of treatment until the very end. Otherwise, a recurrence of the infection is possible.
- Antibiotics for intestinal infections should be taken only when the diagnosis is confirmed and as prescribed by a doctor.
- It is important to drink plenty of fluids to avoid dehydration.
- It is necessary to strictly follow the recommendations of the doctor regarding the dosage and duration of the course of treatment.
In any case, do not self-medicate with antibiotics for intestinal infections. This can lead to complications and worsen health conditions. Consult a doctor, diagnose the disease and treat it in accordance with the appointment of a specialist.
Which antibiotics can be taken for an intestinal infection?
Intestinal infection is a common disease that often causes dysbacteriosis and diarrhea. Treatment of an intestinal infection includes the use of antibiotics, which help to eliminate the causative agent of the disease. However, not all antibiotics are suitable for treating intestinal infections.
Macrolides are one of the names of antibiotics that can be used to treat intestinal infections. These antibiotics are highly effective, but are used in cases where other antibiotics are powerless in fighting the infection.
Tetracycline is another antibiotic that can be used to treat intestinal infections. However, it should not be taken at the same time as medicines that contain calcium, magnesium, and iron, as these substances can make the medicine less effective.
Before starting antibiotics, you should always consult your doctor and analyze the possible side effects of these drugs.
What is the correct way to take antibiotics for an intestinal infection?
Doctor’s advice
If you have symptoms of an intestinal infection such as diarrhea, vomiting, abdominal pain, you should see a doctor. Only he can prescribe the right treatment. Self-medication with antibiotics can worsen the condition and cause complications.
Follow instructions for use
After antibiotics have been prescribed by a doctor, the instructions for use must be strictly followed. Do not stop treatment prematurely, even if the symptoms have already passed. This can lead to a re-infection that is more resistant to treatment.
Take the antibiotic correctly
Antibiotics should not be taken with food, especially fatty and heavy meals. They must be taken at the same time every day to maintain a constant blood concentration of the drug.
Practice good hygiene
Practice good hygiene to avoid reinfection. Wash your hands before eating and after using the toilet. Avoid prolonged contact with sick people. It is also not recommended to share food or utensils with other people during illness.
Watch your diet
You may need to change your diet during antibiotic treatment. It is generally recommended to drink plenty of water to prevent dehydration. Avoid fatty, spicy and sugary foods that can irritate your stomach.
Do not overuse antibiotics
Antibiotics should only be taken when prescribed by a doctor and should not be overused for other conditions. This may lead to a decrease in the effectiveness of antibiotics in the future and the emergence of more resistant strains of bacteria.
Side effects of antibiotics
Despite the general effectiveness of antibiotics, a number of undesirable side effects can occur when taking them.
Intestinal dysbacteriosis – Disruption of the normal intestinal microflora, which can lead to diarrhea, constipation, bloating and other digestive problems. Taking probiotics can help restore normal gut microflora after taking antibiotics.
Allergic reactions – Antibiotics may cause allergic reactions such as pruritus, urticaria, throat swelling or generalized anaphylactic shock. If you have an allergy to antibiotics, you should tell your doctor.
Increased risk of infections – Antibiotics can lower immunity, which increases the risk of infections. If you notice signs of infection while taking antibiotics, you should tell your doctor.
Liver and kidney hazard – Some antibiotics can damage the liver and kidneys if taken for a long time. People who already have liver or kidney problems are advised not to take antibiotics without first consulting a doctor.
In general, antibiotics should only be taken as prescribed by a doctor and strictly in accordance with the recommended dosage. If you experience any side effects while taking antibiotics, you should contact your doctor for advice.
How long should I take antibiotics for an intestinal infection?
The duration of antibiotics for intestinal infections may vary depending on the severity of the disease and the drug the patient is taking. In general, a course of antibiotics to treat an intestinal infection can last from a few days to two weeks.
Be aware that excessive consumption of antibiotics can lead to deterioration of the gut microbiome, which in turn can cause various intestinal diseases and weaken the immune system.
Therefore, it is important to follow your doctor’s instructions and not exceed the recommended dose and duration of antibiotic treatment for intestinal infections. It is also necessary to consume foods containing prebiotics and probiotics to restore gut health after antibiotic use.
What if antibiotics don’t help with an intestinal infection?
An intestinal infection can become a serious problem if not treated properly. In some cases, for example, if the body has become resistant to antibiotics, treatment may not be effective. In such a situation, you should consult a doctor for further advice.
You may need to do more tests to find out why the antibiotics are not working. In addition, your doctor may prescribe you a different antibiotic or a combination of antibiotics.
In some cases, it may be necessary to undergo rehabilitation after antibiotic treatment in order to restore proper bowel function and normalize the microflora. In any case, you should monitor your health and consult a doctor in time.
How to prevent intestinal infection?
1. Practice good hand hygiene
Germs that cause intestinal infections can be passed on by dirty hands. To prevent infection, wash your hands regularly with soap and water.
2. Handle food with care
Food must be kept at the right temperature and prepared correctly. Do not leave cooked food in a warm place for more than two hours.
3. Drink quality water
Intestinal infections are usually caused by drinking water that has not been adequately treated. Use only drinking water from reliable sources.
4. Stay home if you are sick
If you have signs of an intestinal infection, such as diarrhea and vomiting, stay at home and avoid contact with other people until you are fully recovered.
Related videos:
Q&A:
Which antibiotics are recommended for treating intestinal infections?
To treat an intestinal infection, it is recommended to use antibiotics that target the specific type of bacteria causing the infection. These are usually ampicillin, cotrimoxazole, flucloxacillin, or norfloxacin.
What dosage of antibiotics should be taken for an intestinal infection?
The dosage of antibiotics for intestinal infections depends on many factors, including the type of infection, age, weight and health of the patient. Specific dosages should be checked with your doctor.
Can antibiotics cause side effects when treating an intestinal infection?
Yes, antibiotics can cause side effects when treating an intestinal infection. Including diarrhea, nausea, vomiting and allergic reactions. If you experience any unusual symptoms after taking antibiotics, contact your doctor immediately.
How long should antibiotics be taken to treat an intestinal infection?
The duration of antibiotics for intestinal infections also depends on the type of infection and the patient. Usually treatment lasts from 3 to 7 days. But in any case, you should follow all the recommendations of the attending physician and not interrupt the course ahead of schedule, even if the symptoms have passed.
What are the ways to prevent intestinal infection?
There are many ways to prevent intestinal infection, including good hand hygiene, drinking clean drinking water and prepared foods, avoiding eating outside, and keeping food below 5 degrees.