Updates in the Management of Clostridium Difficile for Adults

Kimberly E. Ng, PharmD, BCPS


US Pharmacist. 2019;44(4):HS9-HS12. 

In This Article

Diagnosis of CDI

Patients with three or more unformed, unexplained, and new-onset stools in 24 hours should be tested for CDI.[4] C difficile can be diagnosed by the detection of toxin A and/or toxin B in a stool sample. A stool toxin test should be used as part of a multistep algorithm with glutamate dehydrogenase (GDH) plus toxin; GDH plus toxin, arbitrated by nucleic acid amplification test (NAAT); or NAAT plus toxin, rather than NAAT alone. Enzyme immunoassay (EIA) is also used to detect toxin A or toxin B. EIAs are advantageous because they have a rapid turnaround time. GDH rapidly detects the presence of C difficile in stool samples but does not have the ability to detect production of toxins. Enzyme-linked immunosorbent assay (ELISA) tests for toxin A or toxin B also provide rapid turnaround time and high specificity.[4,5]