Oral vancomycin in Bangkok or Pattaya?

[randymarsh]

I have c diff infection and am allergic to metronidazole.

 

Bangkok Pattaya Hospital does not have oral vancomycin.  They only have the injection which is not effective against c diff.

 

Any ideas if I will find this anywhere?

[Sheryl]

Unfortunately the site that lists all drugs registered in Thailand (www.mims.com/thailand) is acting up so I cannot check if oral vancomycin is available in Thailand right now. However if it were I would expect BPH to have it or at least be readily able to get it.

 

Fidaxomicin would be an alternative to metro and vanco and in fact has been shown to work betetr on starins commonly found in Thailand. https://aricjournal.biomedcentral.com/articles/10.1186/s13756-017-0214-z

 

If the C. difficule colitis was caused by recent antibiotic therapy and is mild, it will sometimes clear on its own once the antibiotics are stopped.

[randymarsh]

I tried fascino pattaya nua also and they don't stock either vancomycin or fidaxomicin (dificid).

 

I think dificid is newer and much more expensive so if I can't find vanco I'm not optimistic about finding dificid.

 

(The average wholesale price for 10 days of therapy with fidaxomicin 200 mg twice daily is $3,360, compared with $1,273 for 10 days of therapy with vancomycin capsules and only $21.90 for 10 days of therapy with generic metronidazole)

 

 

I am a bit stuck now as to where to find either of these.  I am surprised Bangkok Pattaya Hosptial doesn't have vancomycin.  I have checked on mims previously and its available from 2 or 3 different manufacturers here.  I also tried a large local pharmacy in Jomtien and the owner tried to order vancomycin for me and had no luck, even from his contacts in Bangkok.  

 

I might have to fly back for NHS (UK) treatment.

Edited October 29, 2018 by randymarsh

[Sheryl]

OK Mims is back up.

 

It shows no form of oral vanco registered in Thailand, only IV

 

It also shows no brand of fidaxomicin at all

[randymarsh]

1 minute ago, Sheryl said:

OK Mims is back up.

 

It shows no form of oral vanco registered in Thailand, only IV

 

It also shows no brand of fidaxomicin at all

Ok thanks... bad times.  Wonder what happens to thais who get c diff

[Sheryl]

They're treated with metro

[randymarsh]

4 hours ago, Sheryl said:

They're treated with metro

Although it hasn't been recommended as first line treatment for a long time and definitely not advised for any relapses. 

 

Bumrungrad have replied with this:

 

According to your inquiry, Vancomycin tablet form is not available in our hospital 

but we have vancomycin oral solution which is extemporaneous preparation made from injection medicine by aseptic technique

 

One of the sites I googled said something about being able to take orally the powder form that is usually injected.  If that's what they're talking about here then this might be ok.  Sheryl?

 

Here's what I found on Google

 

Vancomycin is available in capsule form for oraluse. However, the powder in vials of vancomycininjection can also be reconstituted with sterile water to make an oral solution

 

https://www.pharmacytimes.com/publications/issue/2015/november2015/vancomycin-injection-for-oral-use-given-intramuscularly

Edited October 29, 2018 by randymarsh