Clostridium difficile - Treatment 

Treating Clostridium difficile infection 

You will only need treatment for a clostridium difficile infection (CDI) if you have symptoms.

No treatment is needed if the bacteria are living harmlessly in your digestive system.

Mild CDI

If you have mild symptoms of a CDI, it is best to stop taking the antibiotics that may have caused the infection, if possible. This will allow the natural 'good' bacteria to regrow in your gut. In many cases where the symptoms are mild, stopping the antibiotics is often enough to ease the symptoms and clear the infection.

Moderate to severe CDI

If you have symptoms that are more troublesome, such as severe diarrhoea or colitis (swelling and irritation of the bowel) you may need to take an antibiotic that can kill C. difficile bacteria.

This will usually be either metronidazole or vancomycin, which should ease the symptoms within two to three days, though it can take around 7-10 days to make a complete recovery

Possible side effects of these antibiotics are stomach ache, feeling sick and being sick.

Treating relapses

In around 1 in 4 cases the symptoms of CDI return; usually within a week of completing treatment. This is known as a relapse.

The recommended treatment option for a first relapse is usually to repeat the original course of treatment.

If you experience a second relapse, then a 14 day course of vancomycin may be recommended followed by further 10-14 day course of an additional antibiotic such as fidaxomicin (a new antibiotic introduced in 2011) or rifaximin.

If you then go on to experience further relapses you may be referred to a specialist in the treatment of persistent CDIs.

There are a number of treatment options available to you:

  • probiotics can be given in combination with antibiotics – probiotic supplements are designed to stimulate the growth of ‘good’ bacteria (although the evidence of their effectiveness in treating CDIs is inconclusive)
  • immunoglobulins – you are injected with a medication designed to stimulate the production of antibodies to fight off the infection

Faecal transplantation

Another new treatment option for recurring CDIs is called faecal transplantation. This is when a sample of liquid faecal matter (stools or ‘poo’) is taken from a healthy donor and then placed inside your colon, by way of a catheter (a tube) that is stuck down your nose and into your colon.

The donated sample can then help stimulate the production of ‘good’ bacteria and restore the normal balance of bacteria inside your digestive system.

While this may sound unpleasant, the treatment does have good results. Initial studies have found the treatment effective in around four out of five cases. However, access to this type of treatment is currently limited.

Page last reviewed: 14/03/2012

Next review due: 14/03/2014


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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Native said on 12 November 2012

This is very incomplete.

For most people with conditions untreatable by anti-bio tics, a faecal transplant sort them out .

Why is this page silent on that. Here in East Kent it is standard practice. If you relative is going with critical CD, insist on a faecal transplant..

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