How to Prevent Clostridium Difficile Infections

Three Methods:Preventing Infections as a PatientPreventing Infections as a Healthcare ProfessionalRecognizing and Treating Clostridium difficile

When it comes to preventing Clostridium difficile infections, judicious use of antibiotics and excellent hygiene measures are key. It is also important to be able to recognize the signs and symptoms of a Clostridium difficile infection, so that appropriate measures can be taken to treat it and to prevent others from becoming infected.

Method 1
Preventing Infections as a Patient

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    Do not take antibiotics unnecessarily.[1] Due to the risk that antibiotics put you at for developing Clostridium difficile, it is important to take them only when they are needed. Antibiotics will have zero impact in treating a viral infection, so your doctor will not advise that you take antibiotics if you have a viral infection such as the flu.
    • Cases of Clostridium difficile almost always arise when you are already taking antibiotics for another illness. It is the taking of the antibiotics that predisposes your gut and makes it susceptible to developing Clostridium difficile.
    • When you take antibiotics (for another illness), they are often effective at treating that illness; however, the antibiotics also kill off many of the good bacteria in your intestine, which normally have a protective effect. With many of the good bacteria gone, your gut is less protected and you become susceptible to a Clostridium difficile infection.
    • If you do have a serious bacterial infection requiring antibiotics, however, it is important that you follow through with treatment. It is not worth foregoing antibiotic treatment in the hopes of preventing Clostridium difficile, because serious bacterial infections that are left untreated are also a cause for concern.
    • Your doctor can help to guide you as to when antibiotics are beneficial for you to take, and when they are not.
    • The antibiotics most frequently implicated in predisposition to C. difficile infection are fluoroquinolones, clindamycin, cephalosporins, and penicillins.
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    Wash your hands regularly.[2] One of the main ways in which Clostridium difficile infections are caught is by touching surfaces that are contaminated with spores from the bacteria. One of the highest risk areas are healthcare facilities, due to the larger number of cases of Clostridium difficile that occur in places such as hospitals, as well as the length of time that spores can survive on surfaces.
    • Especially if you are in a hospital or other healthcare setting, be sure to wash your hands regularly.
    • Wash with soap and warm water for at least 20 seconds. Alternatively, you can use an alcohol-based hand sanitizer that you can carry with you throughout the day.
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    Avoid sharing the same hspace with someone who has diarrhea. If a family member, a friend, or another person in a healthcare facility contracts diarrhea, it is key to avoid sharing the same space as them until the cause of their diarrhea is confirmed. Their diarrhea could be due to Clostridium difficile, which is highly contagious, or to other highly contagious gastrointestinal illnesses, none of which you want to catch. Therefore, keeping in your own separate space and avoiding shared objects can help you to prevent a Clostridium difficile infection or another unwanted illness.

Method 2
Preventing Infections as a Healthcare Professional

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    Ensure that your healthcare facility has an antibiotic stewardship program.[3] One of the key steps in preventing Clostridium difficile infections at the systemic level (at the level of the healthcare system, in places such as hospitals) is to have an antibiotic stewardship program in place. This is a program that ensures that doctors and other healthcare professionals stay fully up-to-date on when antibiotics are needed and advised, and when they are not. It helps to prevent the unnecessary use of antibiotics, and to guide the best possible decision-making on behalf of doctors in this area.
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    Wash your hands.[4] It is key that doctors, nurses, and other healthcare professionals wash their hands regularly. Ideally, healthcare providers should wash their hands every time they enter and exit a patient's room.
    • Washing when you enter ensures that you do not bring any Clostridium difficile spores into the patient's space.
    • Washing when you exit ensures that no germs (including possible Clostridium difficile) are transported out of the patient's space in a way that may infect others.
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    Practice "contact precautions" anytime someone has diarrhea.[5] Because diarrhea is a sign of a possible Clostridium difficile infection, it is important for healthcare staff to practice "contact precautions" anytime a patient has a case of diarrhea. This includes wearing a gown, a mask, and gloves every time they enter the space, and throwing these out immediately after use so as not to contaminate anywhere outside the space.
    • If you are around someone with undiagnosed diarrhea (i.e. the cause is not known, so it may be Clostridium difficile), it is key to avoid touching shared surfaces or shared objects if you do not want to catch (or pass on) the infection.
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    Clean and disinfect any shared surfaces, equipment, or other objects.[6] Use a bleach solution to clean the environment that may be contaminated with Clostridium difficile spores. This is the most effective mode of cleaning and it is what is required in hospital settings.
    • Always use gloves when cleaning and sterilizing equipment, the surrounding environment, and other shared objects.
    • Continue to practice diligent hygiene and cleaning practices until a Clostridium difficile infection has been ruled out with diagnostic tests.
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    Ask the lab to inform you of positive results as soon as possible.[7] Any patient in a hospital or healthcare facility who presents with diarrhea will have a sample sent to the lab to test for the presence of Clostridium difficile. If the test comes back positive, the lab is to inform the staff immediately so that appropriate precautions can be continued around the affected person.

Method 3
Recognizing and Treating Clostridium difficile

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    Recognize potential signs and symptoms of a Clostridium difficile infection.[8] It is important to be able to recognize potential signs and symptoms of a Clostridium difficile infection, both so that the affected person can receive treatment, and also so that others can practice preventative measures to avoid becoming infected themselves. Signs and symptoms to look out for include:
    • Watery diarrhea (at least three episodes per day) lasting for two or more days
    • Fever
    • Abdominal pain
    • Nausea
    • Decreased appetite
    • An increase in white blood cell count
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    Stop antibiotics you are taking if you develop diarrhea.[9] Because Clostridium difficile is an infection that most often arises when you are on antibiotic therapy, if you develop signs and symptoms and test positive for Clostridium difficile it is key to stop your antibiotics immediately. This will prevent worsening of the infection. Your doctor will offer you alternative antibiotics to treat Clostridium difficile, which will most likely be different than the antibiotics you were on in the first place.
    • The general first-line antibiotic treatment for Clostridium difficile infections is an antibiotic called Metronidazole.
    • Other antibiotic therapies that can be tried include Vancomycin or Fidaxomicin.
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    Be aware of the risk of recurrence.[10] Even when Clostridium difficile infections are successfully treated, they recur shortly down the road in approximately 20% of patients. Therefore, after receiving treatment, it is important to be on the lookout for any further diarrhea or other symptoms, and to seek medical help immediately if you suspect that you may have a recurrence.
    • Recurrences will again be treated with antibiotics that are specific to a Clostridium difficile infection.
    • Relapse may present within days or weeks. The clinical presentation may be similar to or more severe than the initial presentation.
    • For people with multiple recurrences, there is a new therapy called a "fecal transplant" (a stool transplant) that is relatively new, but has shown success at effectively treating Clostridium difficile.


  • Probiotics may help prevent Clostridium difficile. Talk to your doctor about your options.[11]

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Categories: Infectious Diseases