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Wed Apr 19 00:38:30 BST 2006

One of the reasons for the increase in C. diff we are seeing is the significant use of h2 blockers & protein pump inhibitors. 
~doug~

  It's also important to note that increasing rates of pmem colitis as a direct result of anti-biotics offsetting colon bacteria balance has not been proven in all anti-biotics. From what I know, clinical trials have already found such phenomena in the more synthetic a-b families such as cephalosporins and quinolones, but the older and slightly "simpler" families such as penicillins and tetracyclines still remain relatively clean, or atleast uncited. Just my 2 cents. :-)

    -Mike F 

  Ben Reynolds <aneurysm_42 at yahoo.com<mailto:aneurysm_42 at yahoo.com>> wrote:
    Avi:

  Actually a single dose isn't without significant
  morbidity anymore even if your concern isn't about
  breeding resistance (which should be a concern no
  matter the length of antibiotic use). In general
  we've seen a tremendous spike in resisitant C. diff
  among our patients but we've recently had a wave
  several surgical patients at my institution develop
  resistant C. diff colitis after a SINGLE dose of
  Ancef. One neurosurgical spine patient went on to
  become toxic and required a total colectomy. 

  Ben Reynolds, PA-C
  Pittsburgh, PA

  --- Avi Roy Shapira wrote:

  > 
  > K.
  > 
  > I don't think he is kidding. 
  > 
  > Single dose of pre-operative prophylactic
  > antibiotics do not induce
  > resistance. It is the prolonged usage of broad
  > spectrum antibiotics
  > that is the main cause of resistence.
  > 
  > The reason is the Red Queen Race Principle of
  > evolutionary theory. If you
  > give long courses of broad spectrum antibiotics, you
  > provide a niche for
  > the resitent bugs to thrive.
  > 
  > But if you give only a single dose of antibiotics,
  > the resistant bugs
  > spend too many resources for maintaining resistence,
  > and therefore, in
  > antibiotic free environment, cannot compete with the
  > non-resistent bugs,
  > like the symbiotic ones we harbour.
  > 
  > For a very good explanation look up a Scientific
  > American article on
  > antibiotic resistance (March 1998 issue)
  > 
  > Avi 
  > 
  > 
  > On Thu, 13 Apr 2006 KMATTOX at aol.com<mailto:KMATTOX at aol.com> wrote:
  > 
  > > 
  > > In a message dated 4/13/2006 8:07:17 P.M. Central
  > Standard Time, 
  > > docrickfry at aol.com<mailto:docrickfry at aol.com> writes:
  > > 
  > > 
  > > I'm not aware of any data that would suggest
  > potential microbes are 
  > > developing 
  > > mass immunities as a result of prophylactic doses
  > of ABs
  > > 
  > > 
  > > You have got to be kidding or in the least
  > attempting to bait others on this 
  > > web site. Surely, you cannot be this naive or 
  > uninformed. 
  > > 
  > > k
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  > > 
  > 
  >
  ==========================================================================
  > Aviel Roy-Shapira, M.D. Soroka
  > University Hospital &
  > Dept. of Surgery A. and Ben-Gurion
  > University Medical School 
  > the Critical Care Unit POB 151, Beer
  > Sheva, Israel
  > 
  > email:avir at bgumail.bgu.ac.il 
  > Fax:972-7-6403260 voice:972-7-6403390
  > 
  > 
  > 
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