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Clostridium Difficile (C. Diff) Prevention

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Sometimes taking an antibiotic to fight one kind of infection can put you at risk of falling victim to a second kind of infection – call it a "one-two punch." Clostridium difficile, often called C. diff., is bacteria that can cause mild to bad diarrhea. Left untreated, infection with C. diff. is linked to dehydration and more serious health issues that can affect the blood, colon, kidney or other organs and may lead to shock and even death.

Public health officials worry because C. diff. infections have increased at a time when other preventable health care associated infections have been decreasing.


Most C. diff. infections occur in people who take antibiotics for another, sometimes very serious, sickness. Your risk for C.diff. lasts for a few months after finishing an antibiotic prescription. While fighting infections from bad germs, antibiotics also kill good germs, making it easier for C. diff. to give the "second punch." Careful use of antibiotics can help lower the risk of C. diff. infections. Doctors should order antibiotics only when needed. Don’t take antibiotics unless they are prescribed for you. Make sure you finish all the medicine unless your doctor tells you to stop. Even though people may get C.diff. after antibiotic use, doctors may treat C.diff. with other antibiotics that kill C.diff. germs.

In Virginia, hospitalizations for C. diff. have more than tripled from 9 to 29 per 100,000 people between 2000 and 2010. The Centers for Disease Control and Prevention (CDC) reports a similar increase nationwide and estimates 14,000 deaths are linked to C. diff. each year in the U.S.

 Symptoms of C. diff. may include: 
  • Diarrhea longer than two days
  • Abdominal cramps or tenderness
  • Loss of appetite
  • Nausea
  • Fever


Most C.diff. infections are linked to getting health care in a clinic, doctor's office, hospital, or nursing home. The germ is found in stool and can spread through person-to-person contact or on the hands of health care providers, visitors, or patients who have touched a germ-ridden surface. Hand washing is the best way to prevent the spread of germs. Patients should wash their hands after using the bathroom and before eating. Alcohol-based hand sanitizer has not proven to be useful in stopping C.diff. outbreaks. Health care providers should clean their hands before and after taking care of a patient and use disposable gloves when caring for a C.diff. patient.


In Virginia in 2010, people 85 years and older were hospitalized with C. diff. more than twice as often as people of the ages 65 to 84. Both age groups were hospitalized more often than younger age groups. Across the country, rates show the same rise in risk of a hospital stay in older age groups as in Virginia. The rate of hospital stays of women with a C. diff. diagnosis was 30% higher than for men in Virginia in 2010.

Rate of Hospitalization with C. diff. - Diagnosis by Age in VA 2010


Nationwide, the CDC estimates at least $1 billion in health care costs due to C. diff. each year. In Virginia, the total hospital cost for patients found with C. diff. was over $157 million in 2009. The average hospital cost for patients with C. diff. was $23,190 compared to $8,860 for patients hospitalized without C. diff. On average, patients in Virginia hospitals diagnosed with C. diff. stayed over 13.2 days in the hospital in 2009, close to three times as long as the average stay of 4.6 days of all other patients.

C. diff. Average Hospital Cost Per Patient VA 2009


  • Talk to your doctor if an antibiotic is ordered and make sure it is the best possible treatment for your illness.
  • Take antibiotics responsibly – only those prescribed for you, and finish the course of medicine even if you are feeling better before the medicine is gone.
  • Tell your doctor if you have been on antibiotics and get diarrhea within a few months.
  • Wash your hands after using the bathroom and before meals. Require others around you to wash their hands, especially health care providers.

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