Madison Area Lyme Support Group

C-diff and Anthelmintics

http://patient.info/health/clostridium-difficile-leaflet
MSIDS (multi systemic infectious disease syndrome – or Lyme with friends) patients visibly wince at the mention of C-diff (Clostridium difficile), a bacteria found in the gut that can force you to quit your treatment. For some, it can cause life-threatening inflammation of the bowel.

The challenge with C-diff is the spores which can be quite resistant. These spores can stay on surfaces for years and spread in the air when disturbed – such as when someone changes the sheets that an infected person has slept in. They can also get into food and other objects particularly if the infected and/or carriers of the spores don’t wash their hands properly.

To healthy folks this posses little to no risk of infection, but if your immune system is weakened due to an infection such as MSIDS, and then you are taking antibiotics to fight the infection, you are more likely to get C-diff than a healthy population due to the changes in the gut which upset the balance of healthy vs unhealthy bacteria.

While the majority of cases occur in health care settings such as hospitals, MSIDS patients are at risk because the antibiotics that are found to lead to C-diff infections are broad-spectrum antibiotics most commonly used in MSIDS treatment such as fluoroquinolones, cephalosporins, penicillins, and clindamycin. Also, using multiple antibiotics over a long period of time, (which is precisely a common treatment for chronic MSIDS infection) increases your risk as does taking proton pump inhibitors to reduce stomach acid.

http://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/dxc-20202389
Common symptoms include watery diarrhea 3-4 times a day for 2 or more days and mild abdominal cramping and tenderness

Severe symptoms include watery diarrhea 10-15 times a day, severe abdominal cramping and pain, rapid heart rate, fever, nausea, dehydration, loss of appetite, weight loss, swollen abdomen, kidney failure, and increased white blood cell count.

http://patient.info/health/clostridium-difficile-leaflet
Currently people with C-diff are given an antibiotic such as vancomycin or metronidazole and should have their own room and toilet facilities, making sure to wash hands, toilets, bedpans, bedding, surfaces, and floors often. Caregivers should wear disposable gloves and aprons, washing hands with soap and water before and after attending the infected. Hand gel may not kill the spores.

Unfortunately, there are cases where the standard antibiotics, even Fidaxomicin, a non-absorbed antibiotic with high selectivity to C-diff, also found to inhibit toxin and spore production, didn’t work. There is concern of antibiotic resistance.

http://www.medicalnewstoday.com/releases/224359.php, and http://www.medicalnewstoday.com/articles/251759.php
Somewhat new are fecal transplants, in which feces from a donor are processed in the lab and then injected into the small intestine and right side of the colon. These procedures, performed by only a few doctors nationwide, have proven effective, but some worry about unknown risks.

If you don’t own a jet and aren’t quite ready to introduce someone else’s poop into your body, there’s good news on the horizon.

http://www.nature.com/articles/srep33642
Researchers at Scripps Research Institute in San Diego, CA, have found that salicylanilides, commonly used to deworm sheep, goats, and cattle, stopped the growth of numerous C-diff strains, even some that cause recurrent infections. Closantel, rafoxanide, niclosamide, and oxyclozanide all showed some effectiveness with Closantel and rafoxanide being the best for halting C-diff growth, but also showed some work against “stationary-phase” C-diff cells – the cells responsible for producing the toxins behind inflammation of the colon as well as the spores that persist on surfaces which increase transmission rates.

Also, the low oral bioavailability and high fecal excretion demonstrates an appropriate gut concentration to target C-diff in the colon.

The study authors, after theorizing that the compounds change the electrical properties of the bacterial cell membranes, created new compounds boosting this cell membrane altering effect, which increased the effectiveness. Also, the newly created compounds didn’t affect the beneficial gut bacteria thereby showing C-diff won’t have to evolve to develop resistance.

Researchers are now testing the compounds in animal models and are in the process of trying to license them as a treatment for C-diff in humans.

http://www.wildcondor.com/one-tough-bug.html  For one person’s experience with C-diff while on MSIDS treatment.

Make sure to talk to your health care practitioner about things you can do to lower your risk of C-diff while on MSIDS treatment.

Some suggestions

*Eat a no sugar diet

*Avoid alcohol

*Eat a no to low carbohydrate diet – particularly omitting things such as pasta, bread, rice, potatoes, bananas, and other carbs which have a high glycemic index

*Take copious pre and probiotics to foster a healthy gut micro biome

*Pulse antibiotics rather than using them continuously, or take an antibiotic holiday periodically

*Try and remind yourself that MSIDS treatment is long, so healthy habits are a must to go the distance.  Everything you do early on has long-term ramifications.