Diagnosis and Management of Clostridioides Difficile Infection in Patients With Inflammatory Bowel Disease

Rahul S. Dalal; Jessica R. Allegretti


Curr Opin Gastroenterol. 2021;37(4):336-343. 

In This Article


CDI is a common but serious complication of IBD that requires simultaneous attention to both conditions. All IBD patients with worsening colitis symptoms should be evaluated for CDI and providers must acknowledge that typical risk factors such as recent antibiotic exposure and pseudomembranes may not be present. Those with positive two-step stool testing should receive oral vancomycin or fidaxomicin as initial therapy and FMT should be considered for those with recurrent disease. Escalation of immunosuppression may also be needed, especially if IBD patients fail to respond to appropriate antimicrobial therapy after 3–4 days. However, treatment decisions should always be individualized.