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Dr. David
Dr. David, Board Certified Physician
Category: Medical
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I was having what appeared to be a gallbladder issue but all

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I was having what appeared to be a gallbladder issue but all the tests were negative. The Parasitology stool test from 3/8 identified a very high 4+ Citrobactor Feundii complex and Candida. I have continued to lose weight and experience intermittent GI issues and right quadrant pain and I have lost 28#’s. We have tried to manage it with natural antibacterials and it is not working well enough. The susceptible antibiotics are Ciprofloxin which I took for 10 days in June of 2015 and I was very unwell while taking it and I hope to not need to take it ever again. Trimeth-sulfa is also a possibility and I am allergic to it, I took it a very long ago (15+ years) and broke out in hives. Ceftazidime appears to be the next possibility and it is an injectable so I am trying to see if it can be compounded to be taken orally to reach my GI tract, or would Intravenous be more advantageous?
JA: How long have you had the pain? What seems to make the pain better or worse?
Customer: I have learned that Cefixime orally might be ab option but it appears to better treat C. koseri ,
JA: Anything else in your medical history you think the doctor should know?
Customer: ooops this has been going on since January of this year and I have lost 28#'s and now weigh 107. I am trying to determine the best antibiotic to take... it's all so tricky. I also have a very high

Hello, this is Dr. David. I am reviewing your question now and will be with you momentarily.

how old are you?

are you having watery stools or loose stools?

have you worked on cutting out gluten out of your diet to see if your bowels get better

also cutting out milk and dairy and lactose out of your diet could help your bowels

you may need to see a GI doctor for gall bladder testing

what is your height and weight now?

Customer: replied 2 months ago.
I am on an elimination diet and have been for some time, My bowels movements are not watery but softly formed. I am 5'4" and weigh 107.
my last blood test in June also shows
Chlamydia pneumoniae IgG 1:256 High Neg: <1:16
Chlamydia pneumoniae IgM <1:10 Neg: <1:10
Chlamydia pneumoniae IgA 1:128 High Neg: <1:16
Customer: replied 2 months ago.
I am trying to determine the best antibiotic to treat Citrobacter feundii complex that is not Cipro or Bactrim and can be taken orally.....I sure appreciate your help
Customer: replied 2 months ago.
I have had a HIDA scan and Ultrasound that were negative for gallbladder issues

this blood test shows .you have had prior chlamydia pneumonia infection, and have build up IgG and IgA antibodies to it

which is normal. IgM is low so that means you don't have a current infection.

it is normal to have ecoli and citrobacter bacteria in your bowels

these bacteria help you break down nutrients so your bowels can absorb them.

Customer: replied 2 months ago.
Bur my body is not absorbing whicj is why I keep loosing weight and I now have osteoporosis as well.Can you help confirm the best target antibiotic for Citrobactor Feundii that is not cipro or Bacrim?
Customer: replied 2 months ago.
Are you still with me?

how old are you?

https://en.wikipedia.org/wiki/Citrobacter_freundii

you should read this

Citrobacter freundii is a common component of the gut microbiome of healthy humans

you shouldn't be trying to diagnose and treat yourself like this.

taking antiboitcs is not a good idea on your own and you can kill good bacteria in your bowels

this can lead to bad bacterial overgrowth like clostridium difficile infections in your bowels.

there are many causes of osteoporosis.

this doesn't mean your bowels are not absorbing.

taking antibiotics is not going to help your bowels absorb nutrients better.

Customer: replied 2 months ago.
I have read that and am working with a dr. that is an MD and a naturalist as well, I am very concerned and am seeking a second opinion to confirm that the Cefixime is the best possible think to take i I am really struggling and know my body cant tolerate a great deal more irrataion from drugs or supplements. I am only looking to gain better knowledge before I start a course of antibiotics that might not be the ultimate best course
Customer: replied 2 months ago.
I truly appreciate your help, perhaps I need to consider another avenue, I thought this might be worth looking into.....Different species of Citrobacter demonstrate different antimicrobial susceptibility profiles. C. freundii is generally much more resistant to antimicrobial agents than C. koseri (C. diversus). In the 1970s, isolates of C. koseri (C. diversus) were usually resistant to ampicillin and carbenicillin but susceptible to cephalothin; in contrast, isolates of C. freundii were usually susceptible to ampicillin and carbenicillin but resistant to cephalothin (25, 29, 40). This characteristic was even proposed for use in species identification (59). However, C. freundii had become more resistant to many antimicrobial agents, including ampicillin and carbenicillin, so classification of species by antibiotic susceptibility pattern is no longer valid.

I would not take another course of antibiotics like this

this is not conventional medicine and the last two course of antibiotics have not helped you.

taking cefixime will not help your bowels either.

you need to improve your diet,

cut out gluten, pasta, bread, cereals, white flour, sodas, sugars, alcohol, milk, and eat more protein, fish, chicken, nuts, fruits and vegetables, salads, and seeds.

Customer: replied 2 months ago.
You pose a good point - what other test should be considered to address the weight loss and why I may not be absorbing nutrients ....

you haven't told me how old you are.

you need to see a dietician and get a calorie count of how much you are eating

you may benefit from a stool fat content measurement.

if you are not eating enough calories, this can cause weight loss.

you need your thyroid hormone levels checked. hyperthyroidism can increase your metabolism and cause weight loss.

Customer: replied 2 months ago.
I have been on a healthy diet for months and I have not taken antibiotics for my gut as of yet.
Customer: replied 2 months ago.
I am 58

you need your thyroid hormone levels checked. hyperthyroidism can increase your metabolism and cause weight loss.

Customer: replied 2 months ago.
My recent thyroid tests all show "in range" including reverse T3Do you feel it is acceptable to have C Feundii at a level of 3+ , I still have fairly consistent right quadrant painI will request a stool fat content test, can you think of anything else

you need to see a dietician and get a calorie count of what you are eating.

you should get a HIDA scan of your gall bladder

you should get an upper endoscopy scope by a GI doctor to check your stomach and duodenum

you should get a gall bladder ultrasound scan.

let me know if you have other questions.
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Customer: replied 2 months ago.
I Have had both a HIDA scan and ultrasound and they showed negative for gallbladder issues
Customer: replied 2 months ago.
I appreciate your attempting to help but I did not get the specific answer I needed....

you haven't had a calorie count of the foods you eat to see how many calories you take in

you haven't had an upper endoscopy scope or colonoscopy to look in your bowels

at your age, you need a colonoscopy as well.

Customer: replied 2 months ago.
I have done an upper in January which showed a hiadal hernia and my last coloncospy was 3 years ago and okay.

what medications are you taking?

Customer: replied 2 months ago.
only bio identical hormones, vitamins and supplements

how much weight have you lost?

and over what period of time?

how intense is the pain in your right upper abdomen? on a scale from 0-10? is it constant or comes and goes?

Customer: replied 2 months ago.
I have lost 38 pounds this year and the pain comes and goes and can and impact my midline too, but it is predominately right side bat rib cage and below. it can get as high as 7-8. I am aware of discomfort and tenderness 60% of the time. they also did a nidline left side ultrasound that is clear.I truly appreciate your walking through this with me.

you should get a stool occult blood test

and a pill endoscopy to look through your small bowels

you should also get an abdominal MRI scan or CT scan with IV and oral contrast

Customer: replied 2 months ago.
Thank you

you are welcome

let me know if you have other questions.
if done for now, please leave Positive Rating of 5 stars so I can get credit for helping you today
we only get credit for helping clients after positive feedback
you may have to scroll up or down to see the ratings area
you can always reach me directly with "a question for Dr. David" in the medicine or oncology categories if you have other questions
here is my website if you need to reach me:
http://www.justanswer.com/medical/expert-dr-david/
Thanks for using JustAnswers.com

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