Prognosis
The expected response to treatment is rapid resolution of fever and diarrhea within 4 to 6 days. The majority of patients respond to initial treatment.
The epidemic strain (Clostridioides difficile B1/North American pulsed-field gel electrophoresis type 1) has led to more serious disease that is more refractory to therapy. As a consequence, there has been an increase in the rate of toxic megacolon and a rise in C difficile-related deaths.
Recurrence rates vary depending on the presentation, immune function, severity of disease, and treatment type and duration. Recurrence rates have been reported to vary from 5% to 50%, although one study found at least one recurrence in 21% of healthcare-associated infections and 14% of community-associated infections.[6] A small number of patients have repeated relapses, necessitating several courses of treatment or trials of tapering or pulsed-dose vancomycin.[21] The risk of developing a first recurrent episode after an initial episode was 25% in one study, with a risk of 38% for a second, 29% for a third, and 27% of a fourth. The risk of severe infection decreased with each subsequent recurrence.[14]
Use of this content is subject to our disclaimer