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Optimer Pharmaceuticals, AŞ Message Board

  • mikeadd Nov 30, 2011 10:45 PM Flag

    Another opportunity, looks like

    Interesting article regarding a British hospital (published in Br J Urol Int) that switched from their regular prophylactic antibiotic regimen of cipro to gentamicin and/or amoxicillin and clavulanate prior to prostrate biopsy procedure. C diff rose to 5x the prior rate, so they switched back to cipro. They attempted the change due to rising rates of C diff in G. Britain attributed to antibiotic resistance. Medscape article so may have to sign up to access.

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    • You screwed up your is what happened... amoxicillin is known to kill off many types of bacteria in the GI. When other bacteria dies, C.diff has no competition in the GI and over-populates the GI causing diarrhea from its toxins. Cipro being more selective in killing does not kill all types of bacteria in the GI as a result, C.diff growth is kept in check by other bacteria growth and you do not have C.diff diarrhea. The issue here is not resistance but keeping a balanced GI flora by choosing the appropriate antibiotic for the infection..... Nice try...know enough to be dangerous but not enough to be good.

      • 2 Replies to jiarealty
      • availability of Dificid to fight c-diff? if not, why? thanks...

      • mikeadd Dec 1, 2011 11:09 AM Flag

        My apologies to the board in posting in my summary of article that there were 5x more cases of C diff after antibiotic change. In fact, there were 5x the amount of other types of infection as is stated in the study below. JIA, your claim that cipro is more selective is . . . well, just read the article again or a portion of it.

        "Almost 13% of the patients receiving co-amoxiclav and gentamicin developed infections compared with just 2.4% of patients receiving ciprofloxacin. Twelve patients were readmitted with sepsis, and 1 patient was readmitted with septic shock.

        "This is the first study to compare the use of co-amoxiclav and gentamicin with the use of ciprofloxacin for [ultrasonography-guided prostate biopsy]," senior author David Neal, FMedSci, FRCS, professor of surgical oncology at Addenbrooke Hospital in Cambridge, United Kingdom, said in a statement. "This audit study supports the use of locally determined prophylactic regimes for this procedure."

        The change in antibiotics had been spurred by rising C diff rates in the United Kingdom, which may have been the result of widespread use of broad-spectrum antibiotics such as ciprofloxacin.

        "The new regime was introduced on the proviso that both the hospital-acquired infection rates and postoperative infection rates would be closely monitored," Dr. Neal said. "Given that there were no cases of C. difficile recorded in our study, but postoperative infection rates increased significantly, the decision was taken to revert back to the original regime." Once that was done the overall rate of infection went back down to 3.8%.

        To JIA, resistance is indeed an issue, which is one of the main reasons Dificid will be a major player, ie, it stays in the GI tract.