Clostridium Difficile Infection: Which Antibiotics Carry the Highest Risk of C. Diff?

January 25, 2021

Colitis, or inflammation of the colon, can be caused by a bacteria known as Clostridia difficile (or more commonly known as ‘C. diff’). It is found throughout nature, particularly in soil and is normally present in the colon, or large intestine. There it is usually kept in check by other bacteria. However, it but can overgrow when the “good bacteria” die off. Patients can develop C. difficile colitis when antibiotics used to treat infections kill these good bacteria, disturbing the normal balance of bacteria in the intestines. This can cause symptoms, like abdominal pain and diarrhea.

Antibiotics with the highest risk of causing C. diff infections:

  • Cephalosporins, especially second and third generation:
    • Lorabid (loracarbef)
    • Cefotan (cefotetan)
    • Zinacef (cefuroxime)
    • Ceftin (cefuroxime)
    • Cefzil (cefprozil)
    • Mefoxin (cefoxitin)
    • Omnicef (cefdinir)
    • Spectracef (cefditoren)
    • Suprax (cefixime)
    • Claforan (cefotaxime)
    • Fortaz (ceftazidime)
    • Cedax (ceftibuten)
  • Cleocin (clindamycin)
  • Amoxil (amoxicillin)
  • Omnipen, Ampi (ampicillin)

Prevention of C. difficile Infections:

The most effective way to prevent C. diff infections is to avoid unnecessary antibiotics. Remember, if your doctor does not want to prescribe you antibiotics, they do this not because they want to keep you from getting better, but they want to prevent harm.

Treatment of C. difficile Infections:

When C. difficile colitis develops it is treated with another antibiotic, Vancocin (vancomycin), or Flagyl (metronidazole). Vancomycin is taken orally in a dose of 125 mg four times a day for 10 days. Metronidazole is taken orally in a dose of 250 mg four times a day or 500 mg three times a day for 10 days.