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Clostridioides difficile infection: do I need antibiotics?

C. difficile is a bacterium that can infect the bowel and cause diarrhoea. The infection is most common in people who’ve recently had antibiotics to treat another bacterial infection. Common symptoms include diarrhoea several times a day, a high temperature, loss of appetite, feeling sick, tummy pain and dehydration. It can sometimes cause serious bowel problems and spreads easily to other people. If you're in hospital, you might be moved to a room of your own during treatment to reduce the risk of the infection spreading. If you’re at home, your GP will advise if you need hospital treatment.

If you’ve been diagnosed as having a C. difficile infection, you’ll be offered a 10‑day course of antibiotics known to specifically kill C. difficile. Any antibiotic you’ve been taking for another infection will be stopped unless it’s essential. In which case, it might be changed to one less likely to cause C. difficile infection.

Your doctor should explain that all antibiotics can cause side effects, such as diarrhoea and nausea (feeling sick). You’ll also be given advice about drinking enough fluids to avoid dehydration and preventing the spread of infection.

Your symptoms should start to improve within a few days of starting antibiotics to treat C. difficile but may take 1 to 2 weeks to clear up completely. Also, the symptoms may come back, and treatment may need to be repeated.

If you're well enough to recover from the C. difficile infection at home, make sure you finish the entire course of any antibiotics prescribed, even if you're feeling better. Also, see your GP if your symptoms suddenly get worse at any time or you feel very unwell after you start the antibiotics. They may refer you to hospital if you have signs of a serious illness.

Making decisions together

Decisions about treatment and care are best when they are made together. Your health professionals should give you clear information, talk with you about your options and listen carefully to your views and concerns.

If you cannot understand the information you are given, tell your health professional.

Read more about making decisions about your care.

Where can I find out more?

The NHS website has more information about:

This organisation can give you advice and support: MRSA Action UK, email

Using antibiotics when they’re not needed means they may not work as well in the future. This is a serious health risk, so NICE has written advice on why antibiotics should be used wisely.

We wrote this guideline with people who have been affected by C. difficile and staff who treat and support them. All the decisions are based on the best research available.

ISBN: 978-1-4731-4196-4

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