What is Clostridium difficile?

C. difficile are bacteria that live in the intestinal tract of 5% of healthy adults and 50% of healthy infants. Taking antibiotics kills the many other bacteria types living in the healthy intestine, but C. difficile often survives, reproduces in huge numbers, and begins secreting a toxin (poison) that attacks the lining of the intestine. C. difficile infection is often called antibiotic-associated diarrhea.

What are the symptoms?

• Abdominal pain, tenderness, and cramping


• Diarrhea, sometimes severe, with blood, mucous, or pus


• Fever

How is C. difficile infection spread?

C. difficile is very infectious. It can be spread by people who have the illness or can be present on environmental surfaces. Usually infection occurs by:

• Your hands pick up the organism from the environment


• The organism enters the mouth from the hands during oral contact, such as eating or drinking


• If antibiotics are given, then the C. difficile has the opportunity to “take over”, causing symptoms

Who is at risk?

• Anyone taking antibiotics. Taking multiple kinds increases the risk


• Hospitalized patients, especially older patients


• Persons on chemotherapy for cancer


• Persons with other inflammatory bowel diseases


• Persons who have had surgery on the gastrointestinal system

How is C. difficile diagnosed?

If you have symptoms, your doctor will ask for a stool sample to be sent to the laboratory for C. difficile testing.

What is the treatment for C. difficile?

• Antibiotics should be stopped


• If diarrhea continues, a medicine called metronidazole (Flagyl) is usually effective when taken orally for 10 full days


• If diarrhea persists despite metronidazole, oral treatment with a medicine called vancomycin is recommended for 10 full days


• As many as 20% of patients experience a relapse, but most respond to a second course of medicine


• Anti-diarrheal medicines should not be used. The toxin must be excreted to prevent more severe damage to the intestine

How can I keep from getting C. difficile?

• Use antibiotics only when necessary


• Wash hands well and frequently when in the hospital

How long does the disease last?

• If antibiotics are stopped, 23% of cases resolve within 2 - 3 days


• If treatment is necessary, diarrhea usually resolves within 2 - 4 days of starting the medicine

If I have C. difficile how can I keep from spreading it?

• Maintain excellent hygiene when using the toilet


• Wash hands well and frequently, especially after going to the bathroom


• If possible, use separate restroom


• Lactobacillus (in yogurt and acidophilus milk) may help reduce diarrhea (unproven)

What type of follow-up care do I need?

Once the symptoms have stopped and the full course of medication has been finished, there is no need for follow-up