Friday, March 14, 2014

Serious Diarrheal Infection in Kids Linked to Antibiotics

A new study by the US Centers for Disease Control and Prevention (CDC) published in the journal Pediatrics finds that most cases of the severe – and potentially fatal – diarrhea illness in children caused by Clostridium difficile infection were picked up outside the hospital and occur among those who have recently taken prescribed antibiotics.
Monday, March 10, 2014

The CDC urges doctors to improve antibiotic prescribing to protect the health of American children. “When antibiotics are prescribed incorrectly, our children are needlessly put at risk for health problems including C. difficile infection and dangerous antibiotic resistant infections.

The human gut is home to over a thousand species of microbe. Kept in the right balance, these microorganisms do no harm and the “friendly” ones even help with processes like digestion and protecting the gut.

But if the balance of these microbe populations is upset – by taking antibiotics, for example – there is a risk of losing vital protection from the beneficial bacteria. This allows C. difficile to grow out of control and release toxins that attack and inflame the lining of the gut, causing colitis.

Although rare compared to other gut bacteria, C. difficile, is one of the biggest causes of infectious diarrhea in the US. According to the CDC, the bacterium causes at least 250,000 infections in hospitalized patients and 14,000 deaths every year. Levels of infection have never been higher than they are at present.

Investigators found that 73% of the children who acquired C. difficile had been taking antibiotics prescribed in an outpatient setting, like a doctor’s office, in the 12 weeks preceding the infection. Most of these children were prescribed antibiotics to treat ear, sinus and upper respiratory infections.

The CDC says research shows at least half of all antibiotics prescribed in doctors’ offices to treat children are for respiratory infections, most of which no not require antibiotics. Dr. Lauri Hicks, director of the CDC’s Get Smart: Know When Antibiotics Work program, says: “As both a doctor and a mom, I know how difficult it is to see your child suffer with something like an ear infection. Antibiotics aren’t always the answer. I urge parents to work with their child’s doctor to find the best treatment for the illness, which may just be providing symptom relief.”

Indiscriminate antibiotic use has threatened the health of this nation. It is encouraging to see the CDC acknowledge this chronic issue. C. difficile is just one example of a bigger problem. MRSA (Methicillin resistant Staphylococcus aureus) is another antibiotic resistant infection that is common place in the US today.

The cure for C. difficile is a rectal implant of healthy bacteria from a closely related family member that lives with you. They must be eating the food you eat and have lived where you live so they have similar bacterial makeup. When done properly, the cure takes less than 24 hours.

Just imagine how powerful and important our gut flora must be to be able to create and cure fatal diseases in such a short period of time. In my office, I estimate 75% of my patients have some form of dysbiosis (altered gut flora) driving their symptoms. Two-thirds of them list digestive problems as their chief complaint. However, the other third have little or no digestive issues. They complain of joint pain, general malaise, impaired immune system, or any number of other, seemingly unrelated heath issues.

Ninety percent of upper respiratory infections are viral. They do not respond to antibiotic therapy. If you seek medical care for yourself or your children for an apparent cold or flu, ask for a throat culture and a CBC (complete blood count) before taking an antibiotic. The throat culture takes three days, but the CBC results only take a couple of hours. A high WBC (white blood cell) count or increase in the neutrophils is indicative of a bacterial infection that might respond to antibiotics. If the CBC warrants a broad spectrum antibiotic and it fails, then the throat culture should direct the physician to a drug for which the infection is susceptible.