WHAT ARE THE TREATMENTS FOR C. DIFF.?
* Be aware that the recommended treatments of illnesses are always being improved. This website was last update on 11/1/2024. The best treatment option MIGHT have changed since that time.
1. Oral Antibiotics:
A. Oral Vancomycin: usually 125 mg 4 x /day for 10 days. (Sometimes longer, Sometimes higher doses)
B. Fidaxomicin (Dificid) 200mg tablet 2 x /day for 10 days
C. Rifaximin is sometimes prescribed after a course of Vancomycin if a person does not respond well to Vancomycin alone.
2. Antidiarrheal agents:
A. Bismuth Subsalicylate (BSS) (Pepto Bismol) - has antibacterial properties against C. Diff. ; therefore, might be of some benefit in treating C. Diff.
B. Imodium and Lomotil are not recommended INITIALLY to treat C. Diff. because they have no anti C. Diff. qualities and may indirectly increase the toxin that are effected the large intestine. They can sometimes be used after c. diff antibiotics are started; however, they must be used carefully to avoid causing constipation or interfering with the desired actions of the c. diff antibiotics.
3. Intravenous Medication:
A. Bezlotoxumab is a monoclonal antibody that is given by vein. It binds to one of the toxins produced by Clostridium difficile. The combination of Bezlotoxumab and Vancomycin or Dificid MIGHT be more effected than just Vancomycin or Dificid alone.
4. Fecal Microbial Transplant (FMT):
A. FMT vis a colonoscopy
B. FMT via a nasal gastric tube
C. FMT via pills (Vowst) FDA approved in 2024
D. FMT via enema (Rebyota)
5. Investigational Treatments:
A. Check for all NIH clinical trials at "clinictrials.gov"
B. VE 303 is new type of FMT that is being tested. This type of FMT has 8 bacterial species in it. This type of FMT MIGHT be available some day and MIGHT be safer than other FMT because it has 8 specific bacterial species--unlike other FMTs, which have a far greater number of bacteria in them (some of which COULD be detrimental, but this is usually NOT the case).
C. Cadazolid (an antibiotic that inhibits DNA synthesis): MIGHT be used in conjunction with vancomycin
D. Surotomycin (antibiotic able to kill both living and inactive c diff)
E. DAV132 (enteric coated activated charcoal)
F. SYN004 (this product ingest IV administered beta-lactam antibiotics (a particular type of antibiotic)
CAUTION:
1. Drugs such as Imodium and Lomotil that decrease diarrhea might be detrimental in the treatment of diarrhea caused by C. Diff. This is because C. Diff. bacteria makes a toxin, and if diarrhea is slowed down, this may leave the C. Diff Toxin in contact with a patient’s colon for a longer period of time. However, this has not been proven.
2. In about 15 to 25% (possibly 50%) of people with a C. Diff. infection, C. Diff. returns. They may require a repeat dose of either Dificid or Vancomycin— or they may need a prolonged course of Vancomycin. Or they might need a FMT. Some people with c. diff unfortunately die because of the illness.
3. All medication, including antibiotics that treat C. Diff and FMTs, have a risk of side effects.
4. Possible Mild side effects are nausea, vomiting, diarrhea, itching, and light to moderate skin rash.
5. Possible Severe side effects are a severe skin rash, an anaphylactic allergic reaction (leading to the inability to breathe and subsequent death if not treated rapidly), and Clostridioides difficile infection (C. Diff.) of the colon.
6. Medications such as creams, lotions, and gels should be tested in small dosages in areas of the body that are not easily seen.
Consult “Epocrates.com” for each Specific Medication’s possible “Adverse Reactions.” Side effects are also referred to as “Adverse Reactions.” Epocrates.com will tell you both “common reactions” and “serious reactions.” You will have to create an account, but it is simple, fast, and free.
WHAT ARE THE SYMPTOMS OF C-DIFF. (CLOSTRIDIODES DIFFICILE)?
The symptoms of C. Diff is usually diarrhea with or without mucous. However, neither diarrhea or mucus has to occur. The diarrhea typically begins 5 to 10 days after starting antibiotics—but may occur on the first day or up to 2 months later. Diarrhea may vary from mild to severe. Stool may be formed, semiformed, watery, or sometimes bloody. Abdominal cramping or pain is common, but nausea and vomiting are rare. The abdomen may be slightly tender.
In the worst cases, patients may have abdominal pain, nausea and vomiting, diarrhea, resulting in dehydration. This may cause them to need to admitted to a hospital for treatment. However, most people who have c diff can be treated at home.
WHAT IS THE CAUSE OF C. DIFF. (CLOSTRIDIODES DIFFICILE)?
C. Diff, Clostridioides D. (formerly Clostridium Difficile) is the bacteria that cause a C. Diff. Infection. This bacteria can a part a person’s normal intestinal flora or can be transmitted to one person to another.
Typically, C. Diff. occurs when a person is given intravenous antibiotics. But, it can occur as a result of taking oral antibiotics, chemotherapy--or may even occur spontaneously without taking type of medication.
HOW IS C. DIFF. DIAGNOSED?
C. Diff. can be diagnosed by a careful history and tests of the stool. The tests of stool are usually composed of a couple different parts. One part is to test the stool for two different toxins, called Toxin A and Toxin B. This test might be done either with an ELISA test or a PCR test. Another part is to test the stool for GDH enzyme.