title: Treatment of RecurrentClostridium difficileDiarrhea.
abstract: Treatment of recurrentClostridium difficile-associated diarrhea can be challenging. Once patients develop recurrent disease, further episodes are common and can continue for months or even a year or more. Treatment begins with a repeat standard 10-day course of antibiotics, followed by tapering and/or pulsing of the antibiotic dose. Probiotics can also be useful, particularly the nonpathogenic yeastSaccharomyces boulardii. Stool reconstitution via fecal enemas, colonoscopy, and nasogastric tubes have been performed to restore normal colonic flora. Additional approaches under investigation, such as vaccination againstC. difficile, show encouraging preliminary results.
authors.affiliation: Dr. Huebner is a Fellow in the Division of Gastroenterology at the University of Washington School of Medicine in Seattle, where Dr. Surawicz is Professor of Medicine, Section Chief in Gastroenterology at the Harborview Medical Center, and Assistant Dean for Faculty Development.
authors.forename: Elizabeth S
authors.initials: ES
authors.lastname: Huebner
authors.affiliation: Dr. Huebner is a Fellow in the Division of Gastroenterology at the University of Washington School of Medicine in Seattle, where Dr. Surawicz is Professor of Medicine, Section Chief in Gastroenterology at the Harborview Medical Center, and Assistant Dean for Faculty Development.
authors.forename: Christina M
authors.initials: CM
authors.lastname: Surawicz
keywords: Lactobacillus GG; Recurrent Clostridium difficile–associated disease; Saccharomyces boulardii; metronidazole; vancomycin