Those who develop Clostridium difficile along with their Inflammatory Bowel Disease may have a harder time treating it with Vancomycin.

A review study of 101 patients who had an Inflammatory Bowel Disease of one kind or another found that Clostridium difficile was more likely to occur in those treated with the antibiotic vancomycin compared to those treated with another antibiotic, metronidazole or a combination of both. Vancomycin goes by the brand name Vancocin while metronidazole is also known as Flagyl.

The review study showed a recurrence rate of almost 40%(39.4%) in those who took vancomycin compared to 14.5% in those who took metronidazole & 13.3% in those who took a combination of both. No obvious differences were found between patients & the vast majority(89%) were on immunosupressive drugs of some sort. Steroid use does seem to play a role as reinfection rates were approximately twice as high, 32% vs 15.7%,  for those receiving a steroidal treatment.

Vancomycin & metronidazole are both considered to be the “last line of defense” antibiotics used only to treat the toughest infections. Clostridium difficile has proved extremely difficult to treat over the years. The study suggests that those with an Inflammatory Bowel Disease like Crohn’s Disease or Ulcerative Colitis should opt for metronidazole or a combination of metronidazole & vancomycin. If you’re looking for a non-drug treatment option, bacteriotherapy is starting to gain traction as a treatment for C. diff.

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