Aging gracefully - Richmond Parents Monthly

Custom Homes • AdditionsRenovations • Remodeling804-651-4078DR RxBy Amy Pakyz, Pharm.D.Dear Dr. Rx: My elderly auntwas diagnosed with C. difficileinfection last year.She was given antibiotic treatment,which seemed to help, but then shegot the infection again. What causesthis infection, and why is it so hardto get rid of?"Quality home by Custom Builder,Still living, and loving it."Richard LaPorteWhat is aC. diff infection?Custom Homes • AdditionsRenovations • RemodelingThe organism Clostridium difficile(pronounced Klos-TRID-e-uhmdif-uh-SEEL), also referred to as “C.diff,” causes a bacterial infection thatis commonly acquired in hospitalsor long-term care facilities. The organismcan be found on items in theenvironment, such as medical equipment,bedrails, bedside tables andtoilets. The infection also can be acquiredoutside the health-care environment,but this is less common.The typical symptoms of C. diffinfection include watery diarrhea occurringmany times throughout theday, nausea and abdominal pain andtenderness. Fever, loss of appetiteand weight loss can also occur.Those who are susceptible tothis infection are the elderly, as wellas those who have a weakened immunesystem. Persons who recentlyhave taken antibiotics — such as inthe past 30 days — or who are currentlytaking antibiotics are especiallyprone to this infection. This is becauseantibiotics can alter the normalmicroflora in the gut and allow theC. difficile organism to proliferate.The risk increases when takingbroad-spectrum antibiotics (antibioticsthat cover a wide range of bacteria),when taking antibiotics for along time period and when takingmultiple antibiotics. The use of protonpump inhibitor agents used to reducestomach acid, such as Prilosec,Prevacid and Nexium, also havebeen associated with an increasedrisk of C. diff infection.C. diff infection is commonlytreated with an antibiotic course ofeither metronidazole or oral vancomycin.In very severe cases of infection,a patient might have to havesurgery to remove infected parts ofthe intestine; although rare, deathalso can occur as an outcome of thisinfection.After being treated for C. diff,the risk of a recurring infection canbe up to 20 percent, or up to one outof every five people who are treatedfor the infection. Generally, the infectionrecurs within eight to 10 weeksafter finishing C. diff treatment forthe original infection. The infectionalso can recur more than one time.Several measures can be taken toprevent C. diff infection. First, makesure that health-care providers cleantheir hands with soap and water oran alcohol-based product before andafter caring for you when you are inthe hospital. Be mindful of cleaningyour own hands often, especially afterusing the bathroom and beforeeating, when in a health-care environmentsuch as a hospital or longtermcare facility.Also, only take antibiotics asprescribed by a health-care professional.The use of narrow-spectrumantibiotics (antibiotics that are effectiveagainst only a limited range ofbacteria) should be used over broadspectrumantibiotics when appropriate.Antibiotics are not useful for thecommon cold or for other illnessesdue to viruses. The use of probioticswhen taking antibiotics may aidin decreasing the risk of C. diff infection,but their use might not be warrantedin severely ill patients. fpThis month’s “Dr. Rx” is Amy Pakyz,an associate professor at VCU Schoolof Pharmacy. After earning her doctorof pharmacy degree, she completed aresidency in infectious diseases. She alsoholds a master’s degree in health evaluationsciences.6a 20 u FIFTYpLUS u Independent september 2013 Living GUIDE u September 2013www.fiftyplusrichmond.com