infectious diseases
Clostridioides (formerly Clostridium) difficile–Induced Diarrhea
Key Points
Antibiotic therapy can cause intestinal overgrowth of toxin-secretingC. difficile, resulting in a pseudomembranous colitis that can be severe and difficult to cure. Cephalosporins (particularly 3rd-generation), penicillins,clindamycin, and fluoroquinolones pose the highest risk. Diagnose using a stool assay forC. difficileantigen and toxin and sometimes PCR testing for the toxin gene. Treat with oralfidaxomicinorvancomycin. Recurrence is common; re-treat with antibiotics, and consider fecal transplantation orbezlotoxumabfor refractory recurrences. 