Prevent Clostridium difficile re-infection

Isolate patient from other high-risk persons -  including other patients, the elderly /immuno-compromised, or those taking antibiotics

Kill C. difficile (including its spores) on hospital or home surfaces:

Cleaning solutions for C. Diff

Exercise stringent hand-washing for patient and patient caregivers

Prevent C. difficile infection

The many spores formed by C. difficile resist most surface cleaning methods and remain viable outside the body for long periods of time.    Disinfection with a diluted sodium hypochlorite solution (commonly known as bleach or chlorox) kills C. difficile on object surfaces.

Cleaning solutions for C. Diff

Certain probiotic strains have shown to prevent antibiotic-associated diarrhea.   There is strong evidence of efficacy for S. boulardii or L. rhamnosus GG in adults or children who are receiving antibiotic therapy. Also, recent research has indicated that L. casei DN-114 001 is effective in hospitalized adult patients for preventing antibiotic-associated and C. difficile diarrhea.

World Gastroenterology Organisation Practice Guideline, Probiotics and prebiotics, May 2008

Williams NT. Probiotics. Am J Health-Syst Pharm. 2010;67:449-458.

Lactobacillus rhamnosus strain GG (LGG) (ATCC 53103).    US patent 4,839,281, named after it's co-discoverers, Sherwood Gorbach and Barry Goldin, was identified as the result of a screening effort that evaluated dozens of strains of lactobacilli to identify those with a certain set of desireable probiotic attributes, namely:

• Stability to effects of bile

• Stability to affects of acid

• Ability to attach avidly to mucosal cells of the human intestinal tract

• Lactic acid production

• Hardy growth in vitro

LGG is available in the USas "Culturelle", which is marketed by CAG Functional Foods and can be bought online.

Gorbach SL, Chang TW, Goldin B.Successful treatment of relapsing Clostridium difficile colitis with lactobacillus GG. (Letter) Lancet 1987;2(8574):1519

Saccharomyces boulardii.   Numerous studies have shown S.boulardii an effective treatment for active C.difficile diarrhea.

•  A non-disease causing yeast;

• Survives passage through the intestinal tract;

• Unaffected by antibiotics - although it can be killed by antifungal medication;

• Disrupts toxins that would normally irritate the intestines - stimulates the intestinal immune system to secrete C. difficile toxin A-specific antibodies (IgA) in the gut.

Qamar A. Aboudola S, Warny M, et al.Saccharomyces boulardii stimulates intestinal immunoglobulin A immune response to Clostridium difficile toxin A in mice.Infect Immun.2001; 69:2672-2765

Lactobacillus acidophilus and Lactobacillus casei proprietary blend (50 billion CFU/capsule) reduced ADD/CDAD in those taking antibiotics -a 2010 study involved 225 hospitalized patients taking antibiotics considered high-risk for C. difficile. Randomly assigned to one of 3 groups, patients took dosages of probiotic blend or placebo (as shown in chart below), begun 36 hours after starting antibiotic course and continued for 5 days after course was finished. Affect on antibiotic-associated diarrhea (ADD) or C. difficile-associated diarrhea (CDAD) was recorded, showing favorable dose-related results for those taking probiotic blend, compared to those taking placebo. Even those patients who experienced AAD on probiotics, had symptoms for a shorter duration than those on placebo.

Miller et al, Dose-Response Efficacy of a Proprietary Probiotic Formula of Lactobacillus acidophilus CL1285 and Lactobacillus casei LBC80R for Antibiotic-Associated Diarrhea and Clostridium difficile-associated Diarrhea Prophylaxis in Adult Patients, Am. J. of Gastroenterology, Published online ahead of print, doi:10.1038/ajg. 2010.11