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Dr Basu
Dr Basu, Experienced Specialist
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Experience:  MD
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My 84 year old mother is in a rehab facility recovering from

Customer Question

My 84 year old mother is in a rehab facility recovering from a total knee replacement. The progress has been slower than we expected. She was diagnosed with cdiff, and is now on her 2nd round of Flagyl. Sorry if that is misspelled. I am being told that this is very hard to get rid of. She is ready to come home in regards ***** ***** knee replacement probably in a week, but she will be taking this antibiotic for at least 14 days. I am thinking of having her seen by a gatroenterolgist to validate the treatment at the rehab center. Help.
Submitted: 1 year ago.
Category: Medical
Expert:  Dr. Ravoof replied 1 year ago.

Dear customer,

Yes it will be beneficial for her to consult a gastroenterologist. However having a relapse is common and this is seen in one in four cases, with the symptoms of C. difficile infection returning usually within a week of completing treatment. In this case the recommended treatment option for the first relapse is usually to repeat the original course of treatment.

Hence what her doctors in the rehabilitation facility have prescribed is standard treatment, still a gastroenterologic consultation will be beneficial.

Take care.

Expert:  Dr Basu replied 1 year ago.

Hi there,

This is Dr Basu, experienced Internal Medicine Specialist.

I am here to address your concerns and provide great service.

C difficile is an opportunistic infection of the intestine.

That can be serious at your mother's age if not treated properly.

Nowadays C diff is often found to be resistant to flagyl alone treatment.

Hence, if her symptoms like watery diarrhea, bloating have not improved, she will need additional medications like oral vancomycin or newer antibiotic called Difficid.

Yes you should request for gastroenterologist consultation for further management.

Best wishes,

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Expert:  Dr Basu replied 1 year ago.

Do you have any question?

Expert:  Dr. Ravoof replied 1 year ago.

Dear customer,

According to the Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA), the reatment of the first recurrence of the infection is usually with the same regimen as for the initial episode. However let the gastroenterologist assess the risk and severity and then decide whether to continue with the current medication or to add or change to another medication.

http://www.cdc.gov/HAI/pdfs/cdiff/Cohen-IDSA-SHEA-CDI-guidelines-2010.pdf

Take care.

Please rate the answer with a five star rating.

Thanks.

Customer: replied 1 year ago.
I am concerned with the exposure to others. We want her out of the rehab and back home . She has two small children living in her home.
Expert:  Dr. Ravoof replied 1 year ago.

Dear customer,

Thanks for your reply.

Basically to prevent its transmission your mother and the other members of the family have to wash their hands regularly. Even those who visit should wash their hands with soap and warm water before and after leaving the room or using the bathroom.

Please read the article linked below to know more:

http://www.health.state.mn.us/divs/idepc/diseases/cdiff/prevention.html

Take care.

Expert:  Dr Basu replied 1 year ago.

Hi there,

Please make sure she is totally free of any watery bowel movement.

Then C diff treatment is considered successful.

THis should be confirmed with stool tests as well.

If stool tests are negative, then do not worry.

Please wash hands grequently with soap and water.

The children should avoid close contacts till clean stool samples.

Best wishes,

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Customer: replied 1 year ago.
How long is the germ live on surfaces?
Expert:  Dr Basu replied 1 year ago.

Usually upto 30 minutes or till dried up.

The surfaces should be cleaned with chlorox wipes.

Best wishes,

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Customer: replied 1 year ago.
I have been told the germ can live for 6 months on hard surfaces
Expert:  Dr Basu replied 1 year ago.

If the surface is cleaned well with chlorox or bleach water, the bacteria will not survive more than 15 to 30 minutes usually.

Use of gloves is important to clean surfaces.

And wash hands with soap and water frequently.

If your mother is free of diarrhea or watery stool for 72 hours, that is taken as sign of full cure.

Best wishes,

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