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Ask the staff of any inpatient care provider what the bane of their existence is and you will probably hear the same answer over and over: Clostridium difficile. Better known as C. diff, it's a species of bacteria that can run rampant in the colon after a person undergoes an antibiotic regimen that kills off the normal intestinal flora.
Pseudomembranous colitis is a rather mellifluous name for a pretty nasty condition. When the intestinal mucosa is damaged by C. diff toxins, a layer of inflammatory fluid forms throughout the colon or large intestine. What builds up must eventually come out and come out it does in the form of foul-smelling, blood and mucous-filled diarrhea. Accompanied by abdominal cramps and fever, it ranks very low on the list of pleasant experiences in one's life.
When a person is diagnosed with C. diff, the first step is halt any currently prescribed antibiotic regimen and begin therapy with oral metronidazole. If that has no effect, the next step is to proceed with a course of vancomycin. Vancomycin can have harsh side effects on both the kidneys and ears, though, and many patients have diarrhea resume after the prescribed course, necessitating a second regimen of the antibiotic.
A Deadly Disease
Here's the kicker:
Die. And while C. diff has not been shown to be antibiotic resistant, the very nature of the infection works against curing the patient via an antibiotic regimen. Pretty much everybody has C. difficile. The Clostridium genus of bacteria, with more than 250 species, is common throughout nature. It's in soil. It's in human and animal gastrointestinal tracts. It's even a common bacteria in infected wounds.
Adding more antibiotics can kill off high levels of C. diff, but when they are stopped, you're still left with the original problem: normal gut flora gone and a few randy C. diff leftover and ready to colonize your gut once again.
If antibiotics are not the solution, probiotics may be. Probiotics are any of wide variety of anti-antibiotics. Instead of killing off bacteria, probiotics work to restore the normal gut flora. They're everywhere now; from regular grocery store yogurt to concentrated capsules available by prescription or over the counter. For quite some time, probiotics such as Florastor have been prescribed alongside antibiotics in order to boost a person's gut flora and head off opportunistic infections such as C. diff.
But what do you do when the normal probiotic options don't have much effect?