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Advances in Diagnosis and Treatment of C. Diff.

Advances in Diagnosis and Treatment of C. Diff.

By Bus and Train

B8: Take the B8 to 18th Avenue and Ocean Parkway.
Walk up the Service Road to end at 591 Ocean Parkway
(Between 18th and Ditmas Ave).
http://www.mta.info/nyct/maps/busbkln.pdf

F Train: Take the F train to 18th Avenue. 
Walk east 5-blocks towards Ocean Parkway.
Cross Ocean Parkway and turn left onto the service road.
Walk up the Service Road to end at 591 Ocean Parkway
(Between 18th and Ditmas Ave).
http://www.mta.info/nyct/maps/submap.htm

By Bus and Train

B48: Take The B48 Bus To Nassau Ave/Manhattan Ave
http://www.mta.info/nyct/maps/busbkln.pdf

G Train: Take The G Train To Nassau Ave/Manhattan Ave
http://web.mta.info/maps/submap.html

Office Hours

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older man sitting on couch in discomfort holding his stomach

A 79 year old gentleman presented to me with profuse watery diarrhea. An exam of the colon revealed yellowish exudates with inflammation. He had recently been on clindamycin. I submitted my findings in a letter to the Annals of Internal Medicine which was published. Several similar reports were published under the title Clindamycin Colitis. The year was 1974.

Since then the bacteria Clostridium was identified and cultured with great difficulty, hence the name Clostridium Difficile. Symptoms and signs include watery diarrhea, nausea, loss of appetite, abdominal pain/tenderness and fever. The incidence of C. difficile has been rising both in the hospital and in the community. It is now the most common hospital acquired infection and is the most common cause of hospitalized acquired diarrhea. The bacteria produce a toxin which causes tissue injury to the colon. Certain individuals are more susceptible to the infection. They are the elderly 65-yrs and older, immunocompromised individuals, those with IBD (inflammatory bowel disease), people in long term care facilities, and individuals who have recently taken antibiotics. The infection is thought to be related to a disturbance in the normal intestinal ecosystem, the host’s microbiome. The host’s normal bacterial flora work to prevent colonization of bacteria which can then lead to disease.

Newer diagnostic tests that are very sensitive and specific are now available to make the diagnosis earlier. Treatment with metronidazole, vancomycin and now fidaxomicin are available but recurrent infection after treatment can occur. The latest innovative treatment available is Fecal Microbiota Transplantation, (FMT). This procedure has been shown to restore the intestinal flora aiding in combating the infection. The procedure involves obtaining stool from a healthy donor and then infusing it via a colonoscope or nasogastric tube.

Antibiotic stewardship (eliminate unnecessary antibiotic treatments) and meticulous hand hygiene are the keys to help limit the number and spread of eliminate the infection. Antibiotics should only be used for well documented bacterial infections. Cleaning potentially contaminated areas with bleach, hand washing with soap and water and isolation of materials and individuals known to be infected will limit the spread.

Learn more about C. Difficile.

Contact us to make an appointment and discuss your concerns.

Author, Dr. W. Erber, August 2015; reviewed 8/26/2015 by Dr. J. Erber.

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Contact Us

Ocean Parkway Location

William Erber, M.D. & Jonathan Erber, M.D.
591 Ocean Parkway
Brooklyn, New York 11218
Phone: 718. 972.8500
Fax: 718. 972.0064

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Nassau Ave Location

Jonathan Erber, M.D.
115 Nassau Ave
Brooklyn, New York 11222
Phone: 718. 972.8500
Fax: 718. 972.0064

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