One Consultant's Regimen for Refractory Clostridium difficile Infection

Stool transplantation, when available, has become the treatment of choice for patients with recalcitrant Clostridium difficile infection (CDI). However, when stool transplantation is not available, clinicians are left on their own, with no single best option among a variety of drugs administered singly or in combination with various tapering or intermittent dosing regimens. One Minnesota clinician now reports his experience treating patients with refractory CDIs by using an 8-week single-antibiotic taper, administered in combination with the fermented dairy drink kefir (a yogurt-like product available in supermarkets).

Twenty-five patients (mean age, 68) in whom two to seven courses of conventional CDI treatment had failed were treated; all …