Controlling clostridium difficile

Abstract

Clostridium difficile infection causes colitis and is closely associated with the use of antimicrobials, probably due to disruption of the normal bowel flora. Avoiding inappropriate antimicrobial use is the most important way to prevent this potentially life-threatening infection. Emergent hypervirulent variants of C. difficile are associated with increased transmission, morbidity and mortality and have caused epidemics in North America and Europe. Cases have also been reported in Australia so intensified surveillance and antimicrobial stewardship is more important than ever. While any antimicrobial can precipitate C. difficile, fluoroquinolones, clindamycin and cephalosporins are particularly implicated. Other drugs, such as proton pump inhibitors, have also been associated with an increased incidence of C. difficile. Severe disease is managed in hospital. For non-severe disease, treatment generally includes supportive measures and treatment with oral metronidazole. Relapse is common.