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The page below is a sample from the LabCE course Clostridium difficile Infection (CDI): Overview, Laboratory Tests and Updated Guidelines.. Access the complete course and earn ASCLS P.A.C.E.-approved continuing education credits by subscribing online.

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CDI: Treatment

The treatment for CDI typically depends on the severity of the infection. When possible, the usual first step in treating CDI is to eliminate any antibiotic(s) that may have triggered the infection. Ironically, the next step is usually the use of antibiotic therapy specifically geared toward attacking the C diff bacteria. Depending on the severity of the CDI, treatment may include one or more of the following:

  • Antibiotic Therapy: Initial therapy for CDI usually involves the use of either vancomycin or fidaxomicin and may involve one or more courses of the antibiotic. In the past, metronidazole (Flagyl) was used to initially treat CDI, however it is currently not recommended as the first line of treatment but can be additionally used if needed.
  • Fecal microbiota transplantation (FMT): This procedure is also known as stool transplant and can be used to treat recurrent CDI’s. FMT involves transferring a stool sample from a healthy, acceptable donor into the patient’s colon to replenish the normal healthy intestinal bacteria in an effort to control the C difficile bacteria.
  • Surgery: For certain patients with CDI complications such as severe pain, toxic megacolon, or severe inflammation of the abdominal wall, surgery may be necessary to remove the affected portion of the colon.
  • Probiotics: Probiotics are organisms, such as bacteria and yeast, which help restore a healthy balance to the intestinal tract. Used in conjunction with antibiotic therapy, probiotics might help to prevent further recurrence of CDI.
  • Lifestyle remedies: Although not a cure, certain lifestyle remedies may be used as supportive treatment for the diarrhea resulting from CDI’s. Drinking more fluids to help prevent dehydration and consuming certain foods such as bananas, potatoes, rice, and crackers may help with the symptoms of diarrhea.
Note: Specific guidelines and recommendations on the treatment of CDI are discussed in more detail in the section on “Updated IDSA/SHEA Guidelines”.