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Suggest Treatment For Diarrhea In An Infant While On Metronidazole Flagyl
Question: Hi doctor. My baby was admitted 2 months ago because of umbillical abcess. They treated her with ampicillin sulbactam via IV for 4 days. My baby was 2 months then. When we were discharged, the dr prescribed an oral equivalent so we can continue at home but my baby qas having diarrhea since then. It has been a little less than 2 months since the last dose of the antibiotic but still, she is having lose runny stools. My baby is exclusively breastfed by the way. We went to a pedia gastro and she only gave supplements to help her gut recover. She gave single dose vit a, probiotic, folic acid, and zinc for a week. But it did not help. Fecalysis showed 0-1 rbc and wbc, +4 mucus. No parasites. She is positive with c. Diff but negative toxins. Stool culture says no bacteria. Pedia gastro gave her hidrasec to lessen water in stool for 3 days. Diarrhea episode reduced from 5 to around 2 to 3 major poops a day. The rest are small poops somewhat like came out because of gas. She is now on metronidazole flagyl 25mg/ml 3.5 ml 3x a day. After 1st dose last night, she pooped at 4am and her stool is watery with mucus. Is this because the drug is flushing the bacteria out? Is this a normal reaction or should i observe first until we finish the 7 day treatment? She is turning 4 months on the 17th. Thanks.
Brief Answer:
It is normal for a child of this age to pass stool several times a day.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have very carefully gone through your query. I am sorry to mention that you are misinformed and that your pediatrician has not taken a correct approach to the problem. Breast milk is the best possible food for a baby and for an exclusively breast fed baby you need not worry about infection. Please note that it is normal for a child of this age to pass stool 10 times a day or even after every feed. It is normal and NOTHING NEEDS TO BE DONE ABOUT IT. It is also normal for the baby to pass stool once in 10 days and that is normal too so long as the stool is not hard and pellet like.
Since you have started flagyl, please complete the course and stop. Please do not go for such medicines unnecessarily. If there was an infection, the pus cell count in stool would have been high. Do not worry about the mucus. You may give folic acid, zinc and probiotics from time to time but nothing further. The antibiotics have unnecessarily cleared the beneficial bacteria and left the resistant C.difficile but you need not worry about that. Just continue to exclusively breast feed your baby.
Let me know if I could help further.
Regards
It is normal for a child of this age to pass stool several times a day.
Detailed Answer:
Thanks for asking on HealthcareMagic.
I have very carefully gone through your query. I am sorry to mention that you are misinformed and that your pediatrician has not taken a correct approach to the problem. Breast milk is the best possible food for a baby and for an exclusively breast fed baby you need not worry about infection. Please note that it is normal for a child of this age to pass stool 10 times a day or even after every feed. It is normal and NOTHING NEEDS TO BE DONE ABOUT IT. It is also normal for the baby to pass stool once in 10 days and that is normal too so long as the stool is not hard and pellet like.
Since you have started flagyl, please complete the course and stop. Please do not go for such medicines unnecessarily. If there was an infection, the pus cell count in stool would have been high. Do not worry about the mucus. You may give folic acid, zinc and probiotics from time to time but nothing further. The antibiotics have unnecessarily cleared the beneficial bacteria and left the resistant C.difficile but you need not worry about that. Just continue to exclusively breast feed your baby.
Let me know if I could help further.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Pedia said it the amount of mucus is not normal and that amoeba is hard to catch in fecalysis thats why she gave flagyl. Before her 1st month, my daughter is already skipping days without poop. And the consistencybis like cake icing. Now its runny and very loose with mucus. Is it normal that suddenly her poop consistency and frequency changed? Previous fecalysis says her wbc is 2-5 before it became 0-1. If there are no prob at all, will giving flagyl damage my baby's gut?
Brief Answer:
Exclusive breast feeding is all that your baby needs
Detailed Answer:
Thanks for writing back. I acknowledge that the amount of mucus is not normal. But if you worry about amoeba, you need to think of the source as well. Amoebiasis is unlikely to occur in an exclusively breast fed baby. Even if I assume amoeba or bacteria to be present (which I doubt significantly), unless there is blood in stool the body has capacity to control it on its own and hence antibiotics are not needed. All that antibiotics would do is to select hte more resistant bacteria as the sensitive ones will get eliminated. Although it will not damage the baby's gut, it will unnecessarily make things worse.
A pus cell count under 5-10/hpf is to be considered acceptable and you need not worry about it. I would not worry about the change in stool frequency as well.
All I would insist you to do is to give exclusive breast feeding. Unless you give something extra, you need not worry.
Regards
Exclusive breast feeding is all that your baby needs
Detailed Answer:
Thanks for writing back. I acknowledge that the amount of mucus is not normal. But if you worry about amoeba, you need to think of the source as well. Amoebiasis is unlikely to occur in an exclusively breast fed baby. Even if I assume amoeba or bacteria to be present (which I doubt significantly), unless there is blood in stool the body has capacity to control it on its own and hence antibiotics are not needed. All that antibiotics would do is to select hte more resistant bacteria as the sensitive ones will get eliminated. Although it will not damage the baby's gut, it will unnecessarily make things worse.
A pus cell count under 5-10/hpf is to be considered acceptable and you need not worry about it. I would not worry about the change in stool frequency as well.
All I would insist you to do is to give exclusive breast feeding. Unless you give something extra, you need not worry.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
You advised to continue giving flagyl since i already started. Why? If you said it's unnecessary. Last question, pedia said flagyl or metronidazole wont cause any antibioric associated diarrhea. Is this true, since i am expecting that the diarrhea should not get worse while on this medication? Thank you for responding.
Brief Answer:
Inadequate dosage of antibiotics may lead to antibiotc resistance.
Detailed Answer:
Thanks again for writing back. Our gut (including that of a newborn) contains bacteria. These bacteria when exposed to an antibiotic (including flagyl or metronidazole) get sensitized and if not given adequately, the next time you use the antibiotic, the organisms can already be resistant to that since they have prior sensitization. Completing the course reduces this possibility. That is the reason that I asked to complete the course.
The medicine is unlikely to make the diarrhea worse.
Regards
Inadequate dosage of antibiotics may lead to antibiotc resistance.
Detailed Answer:
Thanks again for writing back. Our gut (including that of a newborn) contains bacteria. These bacteria when exposed to an antibiotic (including flagyl or metronidazole) get sensitized and if not given adequately, the next time you use the antibiotic, the organisms can already be resistant to that since they have prior sensitization. Completing the course reduces this possibility. That is the reason that I asked to complete the course.
The medicine is unlikely to make the diarrhea worse.
Regards
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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