Recurrent Clostridium difficile infection has been defined as a relapse of symptoms within 2 -8 weeks of successful treatment of an initial episode, and depending upon interpretation is said to occur in up to 35% of people with C difficile infection. A recent review has addressed treatment options for recurrent C difficile infections, which include:
- Tapering and/or pulsed oral vancomycin regimens, targeting spores that are otherwise resistant to antibiotics. The theory is that once these spores germinate, vegetative forms are targeted in this form of regimen. The latest Infectious Disease Society of America (IDSA) guidelines suggest tapered/pulsed vancomycin for management of first recurrences
- Fidaxomicin, a macrolide bactericidal antibiotic which has a narrower spectrum of activity compared to vancomycin and metronidazole, and causes minimal disruption of the gut flora
- Faecal microbiota transplantation – an approach now gaining more traction. This treatment requires a careful approach to be safe and effective, and can be very expensive
More detailed information can be viewed in original review, which can be accessed here.