Clostridium difficile (C. difficile) is an important cause of infectious disease death in the United States. C. difficile was estimated to cause almost half a million infections in the United States in 2011. Approximately 83,000 of the patients who developed C. difficile experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis.
Poor prescribing practices put patients at risk for C. difficile infections. More than half of all hospitalized patients will get an antibiotic at some point during their hospital stay, but studies have shown that 30-50% of antibiotics prescribed in hospitals are unnecessary or incorrect.
C. difficile infections can be prevented by using infection control recommendations and more careful antibiotic use.
Frequently Asked Questions
Guidelines and Recommendations
- Compendium Update: Strategies to Prevent Clostridium difficile Infections in Acute Care Hospitals: 2014 Update
- Update on Hand Hygiene and C. difficile: Rationale for Hand Hygiene Recommendations after Caring for a Patient with Clostridium difficile Infection [PDF 134 KB]
- SHEA-IDSA Guideline Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by SHEA and IDSA [PDF - 549KB]
- Guideline for Disinfection and Sterilization in Healthcare Facilities, 2008
- Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings, 2007
- Management of Multidrug-Resistant Organisms In Healthcare Settings, 2006
- Guideline for Environmental Infection Control in Health-Care Facilities, 2003 [PDF - 1.4 MB]
Healthcare Providers Can
- Prescribe and use antibiotics carefully. Once culture results are available, check whether the prescribed antibiotics are correct and necessary.
- Order a C. difficile test if the patient has had three or more unformed stools within 24 hours.
- Isolate patients with C. difficile immediately.
- Wear gloves and gowns when treating patients with C. difficile, even during short visits. Hand sanitizer does not kill C. difficile, and although hand washing works better, it still may not be sufficient alone, thus the importance of gloves.
- Clean room surfaces thoroughly on a daily basis while treating a patient with C. difficile and upon patient discharge or transfer. Supplement cleaning as needed with use of bleach or another EPA-approved, spore-killing disinfectant.
- When a patient transfers, notify the new facility if the patient has a C. difficile infection.
CDC Expert Commentaries
Core Elements of Antibiotic Stewardship for Nursing Homes
Dr. Nimalie Stone talks about antimicrobial stewardship in nursing homes. Improving the use of antibiotics to protect patients and reduce the threat of antibiotic resistance as a national priority.
Dying From C diff: Who Is Most Vulnerable?
Dr. Nimalie Stone talks about a new study that indicates that the risks for C. difficile infection and death increase with age in every setting.
Testing for Clostridium difficile Infection
Dr. Carolyn Gould talks about which patients should be tested for C. difficile, which testing methods are appropriate, and one thing you should not do.
See Prevention Tools on the Facilities/Settings page.
- Get Smart for Healthcare: Implementing and Improving Antibiotic Stewardship Efforts
- Infection Control in the Multidrug-Resistant Era: Tending the Human Microbiome Pritish K. Tosh; L. Clifford McDonald Clinical Infectious Diseases 2011; doi: 10.1093/cid/cir899
- Advancing Excellence C. difficile Infection Prevention Assessment Checklists