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Treatments and drugs
By Mayo Clinic staffTreatment for pseudomembranous colitis typically involves stopping your current antibiotic and starting an antibiotic that's effective against C. difficile. In rare cases, surgery may be necessary.
Stopping the current antibiotic medication
Treatment 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 that are present in your colon. Although it may seem strange to use antibiotics to treat a disorder caused by antibiotics, treatment with different antibiotics to eradicate the 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, depending on the severity of the inflammation and the medication, 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 in the weeks to months after treatment has been completed. In these cases, treatment options may include:
- Antibiotics. You may need a second or third round of antibiotics to resolve your condition.
- Surgery. If antibiotics aren't working, your doctor may recommend surgery, though this treatment is rarely necessary for people with pseudomembranous colitis. 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).
Preventing recurrences of pseudomembranous colitis
If you've experienced multiple episodes of pseudomembranous colitis or if you have an increased risk of a recurrence, 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 this allows the bacteria in the supplement to travel to your colon, where they help fight the bad bacteria. Some evidence suggests the yeast Saccharomyces boulardii may reduce the risk of recurrent diarrhea associated with C. difficile infection.
- Pseudomembranous colitis. In: Ferri FF. Ferri's Clinical Advisor 2011. Philadelphia, Pa.: Mosby; 2010. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-0-323-05610-6..C2009-0-38600-6--TOP&isbn=978-0-323-05610-6&uniq=210978719. Accessed Aug. 5, 2010.
- Kelly CP, et al. Antibiotic-associated diarrhea, pseudomembranous enterocolitis and Clostridium difficile-associated diarrhea and colitis. In: Feldman M, et al. Sleisinger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa.: Saunders; 2010. http://www.mdconsult.com/book/player/linkTo?type=bookHome&isbn=978-1-4160-6189-2&eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&uniq=200844987-3. Accessed Aug. 5, 2010.
- Thielman NM, et al. Antibiotic-associated colitis. In: Mandell GL, et al. Mandell, Douglas and Bennett's Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa.: Churchill Livingstone; 2009. http://www.mdconsult.com/book/player/book.do?method=display&type=aboutPage&decorator=header&eid=4-u1.0-B978-0-443-06839-3..X0001-X--TOP&isbn=978-0-443-06839-3&uniq=213242872. Accessed Aug. 5, 2010.
- Diarrhea. ADA Nutrition Care Manual. http://nutritioncaremanual.org/topic.cfm?ncm_heading=Nutrition%20Care&ncm_toc_id=19099. Accessed Aug. 6, 2010.
- Parkes GC, et al. The mechanisms and efficacy of probiotics in the prevention of Clostridium difficile-associated diarrhoea. Lancet Infectious Diseases. 2009;9:237.
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