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Treatments and drugs
By Mayo Clinic staffTreatment for pseudomembranous colitis often begins with stopping the antibiotic medication that's thought to be causing your signs and symptoms. Sometimes, this may be enough to resolve your condition or at least ease signs, such as diarrhea.
Switching to a different antibiotic
If you still experience signs and symptoms, your doctor may recommend an antibiotic that is effective against C. difficile or other bacteria in your colon. Although it may seem strange to use antibiotics to treat a disorder caused by antibiotics, treatment with different antibiotics to eliminate C. difficile allows the normal bacteria to grow back, restoring the balance of bacteria in your colon.
The antibiotics used to treat pseudomembranous colitis are usually given by mouth. However, you may be treated with these drugs intravenously or through a tube inserted through your nose and threaded into your stomach (nasogastric tube). Once you begin treatment for pseudomembranous colitis, signs and symptoms may begin to improve within a few days.
Treating recurring signs and symptoms
Even in people who are treated successfully, pseudomembranous colitis can return weeks to months after treatment has been completed. In these cases, treatment options may include:
- More antibiotics. You may need a second or third round of antibiotics to resolve your condition.
- Surgery. Surgery may be an option in people who have progressive organ failure, rupture of the colon and inflammation of the lining of the abdominal wall (peritonitis). Surgery typically involves removing a portion of the colon (partial colectomy).
- Fecal replacement therapy. Healthy stool, usually from a close relative or member of your household, is homogenized and then inserted into your colon. The donor stool can restore the balance of healthy bacteria in your colon. Fecal replacement is a new therapy that has been used successfully at Mayo Clinic.
Preventing recurrences
If you've experienced multiple episodes of pseudomembranous colitis that haven't responded to treatment with antibiotics, you may opt to try:
- Probiotic treatment. Probiotics are concentrated supplements of good bacteria and yeasts that come in capsule or liquid form. You take these supplements by mouth. It's thought that the bacteria in the supplement travel to your colon to help fight the bad bacteria.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Oct. 21, 2012.
- Ferri FF. Ferri's Clinical Advisor 2013: 5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-08373-7..00002-9&isbn=978-0-323-08373-7&about=true&uniqId=343863096-23. Accessed Oct. 21, 2012.
- Kelly CP. Current strategies for management of initial Clostridium difficile infection. Journal of Hospital Medicine. 2012;7:S5.
- Ananthakrishnan AN. Clostridium difficile infection: Epidemiology, risk factors and management. Nature Reviews Gastroenterology & Hepatology. 2011;8:17.
- Johnson S. Meeting the challenge of recurrent Clostridium difficile infection. Journal of Hospital Medicine. 2012;7:S11.
- Mandell GL, et al. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone Elsevier; 2010. http://www.mdconsult.com/books/about.do?about=true&eid=4-u1.0-B978-0-443-06839-3..X0001-X--TOP&isbn=978-0-443-06839-3&uniqId=230100505-57. Accessed Oct. 21, 2012.
- Gallegos-Orozco JF, et al. Successful colonoscopic fecal transplant for severe acute Clostridium difficile pseudomembranous colitis. Revista de gastroenterología de México. 2012;77:40.
- Diarrhea. ADA Nutrition Care Manual. http://nutritioncaremanual.org/vault/editor/Docs/DiarrheaNutritionTherapy_FINAL.pdf. Accessed Oct.21, 2012.
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