GETTING RID OF C DIFF INFECTIONS

It can be tricky to find Clostridium difficile (C diff) infections and even trickier to treat. Over 20% of C diff infections are known to return in those who don't have inflammatory bowel disease (IBD). Those who have IBD are more prone to developing a C diff infection and even more likely to have it return. 

Antibiotics work most of the time 

• Metronidazole is generally the first choice for most C diff infections, at least in the general population. It covers a lot of different intestinal infections including C diff. However, it can make some people nauseous or give them a funny taste in their mouths. Taking the medicine with meals can lessen the nausea.  
• Vancomycin by mouth is often the first choice for sicker patients or those with IBD. When given by IV, kidney damage may result, but that doesn't happen when someone takes it by mouth because the medicines is not absorbed. 
• Metronidazole and vancomycin can be used together with more severe infections.
• Fidaxomicin is a more expensive treatment that has a narrow range of bacteria that it can treat. But fortunately, C diff can be treated with it. It is often used when the other antibiotics do not work. 

Other measures

• It is important to stop any medicines that can slow the intestine, because you want the bacteria to be eliminated as quickly as possible even if that means looser bowel movements. 
• In some cases, steroids other IBD medicines and even acid blockers may be stopped briefly to allow the immune system to help fight the infection. 
• Sicker patients, particularly those with low protein levels or kidney problems, may need to be hospitalized so they can be given IV fluids and watched for further problems.

If C diff returns

If C diff can't be stopped and symptoms continue of it comes back after treatment, the antibiotic may be continued longer, or more likely, the antibiotic may be changed to one of the others and used for a longer time. 

Sometimes, even that doesn't work and a fecal transplant is used to change the bacteria in the intestine.