C. diff is even more common than we thought. The cure? Poop.

C. difficile was responsible for almost half a million infections and was associated with approximately 29,000 deaths in 2011″

From a recent article in the New England Journal of Medicine. Clostridium difficile, or c. diff, is a truly awful hospital- and nursing home-acquired infection that is not easily cured with antibiotics; in fact, antibiotics are often the proximate cause of a c. diff exacerbation (from a previous post I wrote on the infection):

C. diff is more difficult to treat than most other bacteria; a powerful antibiotic such as ciprofloxacin (every traveler’s favorite) will wipe out much in the gut microbiome, but not c. diff. Once the other bacteria is killed off, c. diff spreads, causing inflammation of the colon, which manifests symptomatically as diarrhea, abdominal pain, and fever in mild cases, septicemia in severe. Treatment has historically involved metronidazole or a vancomycin/rifaximin combo, which (typically) does works on c. diff.

But those antibiotic courses are long – up to a month – and only work initially 60% of the time; less often for a second or third bout of c. diff. Sometimes, a patient will have to be in a hospital bed to receive the treatment (in an isolation bed, which are always in high demand).

The solution? Poop. I’ve written enough about fecal transplants that it isn’t worth re-hashing here, but suffice it to say that the procedure is remarkably effective at tamping down a c. diff  exacerbation.

Nearly 30,000 Americans are killed annually by c. diff, which is nearly as many as are killed by motor vehicle accidents. They don’t have to be; fecal transplants are a cheap, and effective treatment, with few side effects to boot. Cue all the frustration.

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