Treatment options

Ironically, the first line of treatment after diagnosis of C. diff is more ... ANTIBIOTICS!  The type of antibiotic used varies on the severity of infection. For mild to moderate infections flagyl is used. For more severe infection or for recurrent infections vancomycin is used. Surgery is the last resort for those who have suffered from organ failure or severe inflammation that damaged the lining of the GI tract. The damaged part of the tract is then removed.

Unfortunately, up to 20% of patients with C. diff will get sick again. This may be do to the fact that the initial infection never went away or because the patient was reinfected with another strain of the bacteria after the first round of antibiotics. This is called recurrence. Recurrence of a new infection is about 20% and after the first recurrence the chance of continual recurrence is up to 65! Certain populations are at greater risk for recurrence than others. These are:

• An older adult (65+)
• Are taking other antibiotics for a different condition while being treated with antibiotics for C. diff
• Have severe underlying medical disorder such as chronic kidney failure, inflammatory bowel disease or chronic liver disease 

Treatment for recurrent disease can include more antibiotics, which can pretty much just start this vicious cycle. Increasingly, hospitals are looking towards fecal microbiota transplant as a a form of  treatment for patients with recurrent episodes, though it has yet to be approved by the FDA. Fecal microbiota transplant (FMT) is also known as a stool transplant. FMT restores health intestinal 

bacteria by placing another individual's stool in our colon using a colonoscope or nasogastric tube. Donor stools are carefully and repeatedly screened for parasites, viruses, bacteria and certain antibodies before being used for FMT. Below is a video with more information from Mayoclinic: