Clostridium difficile infection: emerging concepts and treatments

Clostridium difficile infection has become one of the most common causes of diarrhea in patients frequenting hospitals, skilled nursing facilities, and physicians' offices. Although the pathogenesis and clinical description were well elucidated three decades ago, cure during the initial episode now occurs in fewer than two thirds of patients exhibiting clinical illness. The past decade has brought a new strain with more toxin. Frequent relapses in elderly patients are now the norm rather than a rarity. This review is intended to update clinicians regarding diagnosis, infection control, and treatment, including treatment of the difficult-to-treat patient with multiple relapses of C. difficile infection.