Clostridium difficile infection
ICD-10 A04.7 · ICD-11 1A04

Treatment of C. difficile Infection in Inflammatory Bowel Disease with an Acute Flare

Clinical Scenario

This protocol covers patients with inflammatory bowel disease (IBD) who present with an acute flare associated with diarrhea and confirmed Clostridioides difficile infection. The coexistence of active IBD and CDI is a distinct clinical challenge: diarrhea can be mistakenly attributed to the underlying IBD flare alone, making confirmed microbiological diagnosis essential before initiating targeted management.

Treatment Approach

Management in this setting incorporates fecal microbiota transplantation (FMT) as a key intervention. The full protocol specifies patient eligibility, when this approach applies, and the complete management pathway — details that go beyond what is shown here.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.14309/ajg.0000000000001278
  1. We recommend C. difficile testing in patients with inflammatory bowel disease (IBD) presenting with an acute flare associated with diarrhea (strong recommendation, low quality of evidence).
  2. We suggest vancomycin 125 mg p.o. 4 times a day for a minimum of 14 d in patients with IBD and CDI (strong recommendation, very low quality of evidence).
  3. FMT should be considered for recurrent CDI in patients with IBD (strong recommendation, very low quality of evidence).
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