A
ntibiotic treatment for an initial
Clostridium difficile infection typically does
not induce a durable response in approxi-
mately 15 to 26% of patients.
1-3
An effective
treatment against recurrent C. difficile infection is
not available. Generally, repeated and extended
courses of vancomycin are prescribed.
4
The estimated
efficacy of antibiotic therapy for a first
recurrence is 60%, a proportion that further declines
in
patients
with
multiple
recurrences.
Mechanisms that have been proposed for recurrence
include
persistence
of
spores
of
C.
difficile,diminished
antibody
response
to
clostridium
toxins,
and
persistent
disturbance
with
a
reduced
diversity
of
intestinal
microbiota.
8-12
2,5-7