I would like to know why just 3 months ago I did great on xifacan and now that I've went back on am doing terrible.

alleykat ..our intestines are like moving targets if you ask me!!!! but we do develop resistance to them as we all know for starters..might work great for a time not thereafter.. if its not cdiff(get that checked out because xifaxin and others do not work for it as yu know must use flagel or vancomycin).. but my own history was i once was able to use xifaxin and have not been able to for years since..use others instead just cannot beat myself up with worrying about using the desired antibiotic like xifaxin if it stops working..

i have used amoxicillan,tinderbox,reflex,augmenting..if not c-diff ask for one of those..

rifaximin had not worked for my son at dose of about 600 a day but when we went to 2200 a day with a week of cipro and then weaned down to 600 it is working for 4 months now - used to have to rotate every 2-4 weeks.

thats very interesting info on xifaxin..2200! how many a day of what mg..want to save that fact and run it by shen..who is your dr and where is he..just curious..as i recall last time i took xifaxin was years ago tried to up it to 8 a day i think most shen said..did not work and thereafter came down with c-diff..your son was lucky that sounds like a lot of killing power..i would worry for me about getting c-diff..again but great it worked for your son..

I think somewhere down the road my GI told me to double the dose for 2 weeks. But never two antibiotics at once. Yes, who is your doctor? I might want to get another opinion and I see your in New York.

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But never two antibiotics at once.

I can't agree with this as many GI doctors recommend taking cipro and flagyl together. They come from different antibiotic families, work on different bacteria and therefore give you the broadest possible spectrum of coverage. Cipro and flagyl in tandem have stamped out many a pouchitis flare for me in 20 years.

However, it is true that many people cannot handle the side effects of one of these drugs or the other (or both), and therefore for that reason alone, they could be difficult to take together from a side effect management standpoint.

Certainly, there are certain antibiotics you would never want to take together. Cipro and levacquin, for example, are from the same family of fluoroquinolone antibiotics. Taking them together would essentially amount to incest. On the other hand cipro and flagyl come from totally different families, and the marriage is appropriate.

In any event it is all trial and error as to what works and what does not work. I have used a rotation successfully for many years and cipro-flagyl is the only cocktail in that rotation. Frankly based on my experience over 20 years, staying on any one antibiotic for more than 2 months is a recipe for disaster and you should be proactively rotating antibiotics that are proven to work. Some Docs will tell you "stick with whatever is working", but my experience is that your luck will eventually run out and you should not sit around and wait for that to happen.

again i concur what ct barrister is saying..and have experienced the same thing...cannot stay on any antibiotic indefinitely ..and although some i use are good to go again when rotating them after period of time(trial and error) xifaxin irked for me once years ago in my rotation but has never worked since as i mentioned on another thread..

ct barrister seems to have worked out for himself presently a successful rotation and diet usage..bravo for ct barrister!!!!

i think you and i(alleykat) and some other members are still trying to figure out the correct balance between antibiotic usage with our diet changes for us so we do not crash so much or so badly..

right now all i know is i need both elements antibiotics and diet..working on balance...

Yup, can't take flagel or tindmax. Maybe that's why 2 were never recommended but xifacan and another, this is a first.

Um, I think two different fluroquinolones together is more like overdose than incest (just in case some people did not get the joke).

Jan

I think my son has some of same doctors plus a pediatric GI, plus a functional doctor. Dr. Shen originally said go up to 2000 rifaximin ( it comes in 550 pills - so went to 2200) It was not working at first and since cipro has been what worked I asked local GI about trying with cipro for a week - in fact no doctor suggested that - it just seemed to work. HOWEVER, now 5 months in - nightime incontinence has seemed to increase - though no other symptoms of pouchitis ( no liquid, no feeling sick and I don't think inflammation - though will get latest cal- protectin test back next week.) Writing this makes me wonder about adding in cipro for a week...hmmm. Also, fyi a Genova stool test from a functional doctor showed that augmentin was not effective for my son - he had been on that for a while.

My functional med dr told me I can't take a stool test until I'm 2 weeks off antibiotics. I would love to take one if the time ever come

I have sibo... BAD.. weight loss, malnutrition, etc. Rifaxamin worked at first. then fodmap diet helped. Then rifaxamin quit working after about 6 months. Then did tindamax, (I'm allergic to cipro and flagyl). Also did bactrim, oral vancomycin, and doxycyline. The end ones were rotated about every 3-4 weeks or dropped immediatley if they made me sicker.. like doxycyline.
We did figure out a plan though... in my rotation if sibo gets bad enough again to go back on antibiotics.. its bactrim, rifaxamin, and oral vanco (though that caused me hearing loss!) with 10-14 days each on it. No more than 2weeks on anything because of developing resistance. And of particular importance because I have so many antibiotic allergies.

anyways.. with all of that.. my gi (both shen at CC and my local GI) told me DO NOT do probiotics.. because if your gut flora homeostatis is so messed up and sensitive.. its just adding another puzzle piece into the mixed up picture.

So when sibo creeps back up about every 5 days. I go straight to a liquid diet, become diligent about minimizing FODMAPS, and pray I don't have to go back on antibiotics. With that said.. I just got put on bactrim for a skin infection and my oh my my gut feels so much better!

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its bactrim, rifaxamin, and oral vanco (though that caused me hearing loss!) with 10-14 days each on it

That is a good rotation because the xifaxin is not systemically absorbed and kind of gives your body a breather between the other two antibiotics.

My Docs also told me no probiotics but only when I am taking antibiotics, because they said it is simply wasted. They have advocated probiotics being attempted if a remission can be achieved through antibiotics. Both my old NYC GI and my new Connecticut GI told me this. The Connecticut GI is a protege of Dr. Shen who did a Fellowship at Cleveland Clinic.

interesting..might have learned something here..about probiotics with antibiotics(liz says its messes you up,ct says its just a waste) but interesting cullturelle says on package can be taken when taking antibiotics???

hmm,may have learned something new here..(liz says taking antibiotics with antibiotis messes you up,ct says dr. said its just a waste) strangely cullterelle ,which is lactobacillus gg says can be taken with probiotis...just i think hours apart..

They honestly don't know for sure about probiotics while taking antibiotics, because the studies haven't been done that way. So we're dealing with dueling educated guesses. IMO it's best not to get too adamant about guesswork.

Shen is blah on probiotics. He always says theres no real medical evidence. However he does say try it to lots of people. Thing is though... you can't change multiple variables at a time and run a valid experiment. So if you are throwing antiotics and probiotics together how do you know if anything worked, and if so which one. Also if antibiotics got you back to a better equilibrium on their own.. why throw fuel on the fire (aka probiotics)

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Also if antibiotics got you back to a better equilibrium on their own.. why throw fuel on the fire (aka probiotics)

...or money down the toilet, so to speak!

Jan

now jan that sounds exactly like something dr. shen would say. and to think you haven't even met the man!