Clostridium difficile 


C difficile

The symptoms of C difficile range from mild to very severe diarrhoea. Get expert advice on how to avoid it, how it spreads and treatments that can control the disease.

Media last reviewed: 14/05/2013

Next review due: 14/05/2015

A clostridium difficile infection (CDI) is a type of bacterial infection that can affect the digestive system. It most commonly affects people who are staying in hospital.

The symptoms of CDI can range from mild to severe and include:

  • diarrhoea  
  • a high temperature (fever) of or above 38C (100.4F)
  • painful abdominal cramps

CDI can also cause life threatening complications such as severe swelling of the bowel due to a build-up of gas (this type of swelling is known as toxic megacolon).

Read more about the symptoms of clostridium difficile and complications of a clostridium difficile infection.


Spores of the C. difficile bacteria can be passed out of the human body in faeces (stools) and can survive for many weeks, and sometimes months, on objects and surfaces.

If you touch a contaminated object or surface and then touch your nose or mouth you can ingest the bacteria

The C. difficile bacteria do not usually cause any problems in healthy people. However, some antibiotics can interfere with the balance of 'good' bacteria in the gut.

When this happens, C. difficile bacteria can multiply and produce toxins (poisons), which cause symptoms such as diarrhoea.

Read more about the causes of a clostridium difficile infection.


A mild CDI can usually be controlled by withdrawing treatment with the antibiotics causing the infection.

More severe cases can be treated using the following antibiotics:

  • vancomycin
  • metronidazole

The condition usually responds well to treatment, with symptoms improving in 2-3 days and clearing up completely within 7-10 days.

However a return of symptoms (relapse) is common occurring in around 1 in 4 cases. A relapse will require further treatment. Some people have two or more relapses.

Life threatening cases may need surgery to remove a damaged section of the bowel which is required in around 1 in a 100 cases.

Severe cases of CDI – especially when they occur in people who were already very ill – can be fatal.

Read more about treating a clostridium difficile infection.


C. difficile bacteria spread very easily. Despite this, CDIs can usually be prevented by practising good hygiene in healthcare environments, such as washing hands regularly and cleaning surfaces using products containing bleach.

If you are visiting someone in hospital you can reduce the risk of spreading infection by washing your hands before and after entering the ward. Alcohol hand gel is not effective against C. difficile spores, so the use of soap and water is essential.

Read more about preventing a clostridium difficile infection.

Who is affected

As CDIs are usually caused by antibiotics, the majority of cases happen in a healthcare environment, such as a hospital or care home.

Older people are most at risk from infection. People aged over 65 account for three quarters of all cases.

In recent years, the number of CDIs has fallen rapidly. There were 17,414 reported cases in England during 2011 compared to 52,988 in 2007.

Unfortunately a new strain of the C. difficile bacteria, called NAP1/027, has emerged in recent years. This new strain tends to cause more severe infection.

There has also been an increase of CDI cases occurring outside of a healthcare setting (known as community-acquired clostridium difficile infection).

Page last reviewed: 14/03/2012

Next review due: 14/03/2014


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