What are the determining factors in choosing an antibiotic for Clostridium difficile colitis (C diff) recurrence?

Updated: Jul 25, 2019
  • Author: Faten N Aberra, MD, MSCE; Chief Editor: BS Anand, MD  more...
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Answer

For the first relapse, the choice of antibiotic should be based on the severity of C difficile diarrhea/colitis. Mild symptoms of recurrence in patients who are otherwise well may be managed without further antibiotic therapy. Initial recurrence that is not severe can be treated with metronidazole. For subsequent recurrences, patients may benefit from vancomycin in a prolonged tapered and/or pulse regimen or fidaxomicin with or without probiotics. Rifaximin is also a potential option.


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