From the Guidelines
Patients can resume a regular diet without restrictions while being treated for C. diff, and adequate consumption of dietary fiber is encouraged to promote beneficial short-chain fatty acid production by gut flora. According to a study published in Clinical Gastroenterology and Hepatology in 2019 1, there is no need for dietary restrictions, and patients should be instructed to consume a regular diet. This approach is supported by the fact that restricting diet may not be necessary, and a balanced diet can help support the recovery of the gut microbiome.
When considering the management of C. diff, it is essential to focus on staying well-hydrated and consuming foods that are gentle on the digestive system, especially during active symptoms like diarrhea. While probiotic-rich foods such as yogurt with live cultures may be beneficial, it is crucial to take them at different times than antibiotics (at least 2 hours apart) to maximize their effectiveness. Some patients may find that a low-fiber, bland diet helps reduce symptoms during acute illness, but this should not be a long-term approach.
As symptoms improve, patients can gradually return to their normal diet, and it is essential to educate them on anti-microbial stewardship, as evidence shows significantly increased recurrence risk with antibiotic use for patients who fail multiple treatments within 8 weeks 1. Overall, the goal is to provide necessary nutrients while the treatment works to eliminate the C. diff bacteria and allow the gut microbiome to reestablish balance.
From the FDA Drug Label
Administration with Food Inform patients and caregivers that DIFICID tablets and oral suspension may be taken with or without food. In a food-effect study involving administration of DIFICID to healthy adults (N=28) with a high-fat meal versus under fasting conditions, Cmax of fidaxomicin and OP-1118 decreased by 21.5% and 33. 4%, respectively, while AUC0-t remained unchanged. This decrease in Cmax is not considered clinically significant, and thus, DIFICID may be administered with or without food.
Patients can eat when being treated for C. difficile with fidaxomicin. The drug may be taken with or without food 2.
From the Research
Treatment of C. difficile Infection
- The treatment of C. difficile infection (CDI) has undergone significant changes in recent years, with advances in diagnostics, newer antibiotics, antibody treatments, and microbiome restoration therapies 3, 4.
- The cornerstones for the treatment of CDI are vancomycin and fidaxomicin, with metronidazole being used only in mild-to-moderate disease in younger patients who have no or only few risk factors for recurrence 4, 5.
- For patients with recurrent CDI, bezlotoxumab infusion (a monoclonal antibody against C. difficile toxin B) may be considered as an adjunctive therapeutic strategy in addition to standard care 4, 5.
- Faecal microbiota transplantation (FMT) is a promising therapy for patients with frequently recurring CDI, with a success rate of over 85% 3, 5, 6.
Dietary Considerations
- While the provided studies do not specifically address dietary considerations for patients being treated for C. difficile infection, it is generally recommended that patients with CDI follow a bland diet to help manage symptoms 7.
- However, there is no clear consensus on specific dietary restrictions or recommendations for patients with CDI, and further research is needed to determine the best approach to nutrition and hydration during treatment 3, 4, 5, 6, 7.
Patient Care
- Patients with CDI should be managed by a healthcare professional, and treatment should be individualized based on the severity of the infection and the patient's overall health status 3, 4, 5, 6, 7.
- Patients with severe or recurrent CDI may require hospitalization and close monitoring to manage symptoms and prevent complications 3, 4, 5, 6, 7.