Clostridium Difficile Infection

Treatment

The first line of treatment for Clostridium difficile is aggressive use of specific antibiotics that kill the C. difficile bacterium:

• Metronidazole (Flagyl) is the first choice to treat mild to moderate C. difficile. It is not recommended for pregnant women because of side effects.
• Vancomycin (Vancocin) is recommended for severely ill patients.

If you are dehydrated you may be hospitalized for close monitoring, and to receive antibiotics and rehydration.

Surgery

In rare cases, surgery may be needed if you have severe C. difficile infection, complications such as hemorrhage or bowel perforation, or if your condition does not improve with medication.

• Colon removal. If your colon is damaged by inflammation or is perforated, your doctor will recommend removing your colon (colectomy).
• Brooke ileostomy. With colon removal, you will need to have your small intestine surgically attached to your abdominal wall (ileostomy) so that you can eliminate waste through an opening (stoma) into an ileostomy pouch.

Relapse

In as many as 30 percent of people, the C. difficile infection returns after their antibiotic treatment (relapse). The risk of relapse is higher if you have:

• Leukocytosis — a large increase in white blood cells in the blood
• Chronic kidney failure
• Colon diverticula
• Had recent abdominal surgery

Treating a recurrence of C. difficile involves taking antibiotics or restoring the healthy bacteria in your intestines with nonpathogenic yeast such as Saccharomyces boulardii.

Read more about C. difficile treatment on MayoClinic.com.