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Home | Articles | Infectious Diseases | Clostridiodes difficile Infection

Clostridiodes difficile Infection

Last updated 17th November 2022

Aetiology, Presentation and Diagnosis

  1. Important bacterial cause of infective diarrhoea.
  2. Most commonly occurs in people who have had a course of antibiotic within the last two months
  3. Some antibiotics are more likely than others to cause CDI, especially coamoxyclav, cephalosporins, ciprofloxacin and clindamycin (the four Cs)
  4. Outbreaks can occur in hospitals and care homes
  5. Symptoms can range from mild diarrhoea to life threatening inflammation of the bowel
  6. In mild to moderate infection there may be watery diarrhoea with cramping abdominal pain, nausea and fever.
  7. Symptoms of severe infection include watery diarrhoea up to 15 times per day with blood or pus in the stool in addition to the above
  8. Diagnosis requires demonstration of C. diff toxin in liquid stool
  9. Click here for link to other causes of acute diarrhoea

Management Including Treatment of Recurrent CDI

  1. For management of CDI see flow chart below – oral Vancomycin is now used first line in all cases
  2. Daily severity review is required for each patient by the medical team (sticker inserted into notes)
  3. For information on recurrent presentations or alternative routes of administration of vancomycin (if oral route is compromised), please contact the duty microbiologist or the infectious diseases consultant on call
  4. Note: Discontinue C. diff treatment if stool sample is Clostridiodes difficile toxin negative or alternate diagnosis confirmed

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Content by Dr Sharon Irvine, Consultant Physician