Can Clostridioides difficile (C. diff) infection be caused by Augmentin (amoxicillin-clavulanate)?

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Last updated: June 6, 2025View editorial policy

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From the Guidelines

Yes, Augmentin (amoxicillin-clavulanate) can cause Clostridioides difficile (C. diff) infection. According to a recent study published in the World Journal of Emergency Surgery 1, antibiotics play a central role in the pathogenesis of CDI, and penicillins, such as amoxicillin-clavulanate, have been associated with a higher risk of CDI. The study highlights that antibiotic exposure disrupts the normal gut flora, providing a perfect setting for C. difficile to proliferate and produce toxins.

Key factors that increase the risk of CDI when taking Augmentin include:

  • Longer treatment courses
  • Higher doses
  • Age more than 65 years
  • Comorbidity or underlying conditions
  • Inflammatory bowel diseases
  • Immunodeficiency
  • Malnutrition
  • Low serum albumin level

It is essential for patients taking Augmentin to be aware of symptoms like watery diarrhea, abdominal pain, and fever, which could indicate C. diff infection. If these symptoms develop during or after Augmentin treatment, medical attention should be sought promptly, as C. diff can range from mild to life-threatening and typically requires specific treatment with antibiotics like oral vancomycin or fidaxomicin.

In cases of suspected severe CDI, antibiotic agents like Augmentin should be discontinued if possible 1, and antimicrobial therapy with agents that are less frequently implicated with antibiotic-associated CDI should be used. Hand hygiene with soap and water and the use of contact precautions along with a good cleaning and disinfection of the environment and patient equipment are crucial in preventing the transmission of C. difficile.

From the FDA Drug Label

  1. 3 Clostridium difficile-Associated Diarrhea (CDAD) Clostridium difficile associated diarrhea (CDAD) has been reported with use of nearly all antibacterial agents, including amoxicillin and clavulanate potassium, and may range in severity from mild diarrhea to fatal colitis.
  • Yes, Clostridioides difficile (C. diff) infection can be caused by Augmentin (amoxicillin-clavulanate) as it alters the normal flora of the colon, leading to overgrowth of C. difficile 2.
  • The development of CDAD should be considered in all patients who present with diarrhea following antibacterial use.
  • Key points to consider when treating patients with Augmentin include careful medical history and monitoring for signs of CDAD.

From the Research

C. diff Infection and Augmentin

  • C. diff infection is a type of bacterial infection that can cause diarrhea and colitis, and it is often associated with the use of antibiotics 3, 4, 5, 6, 7.
  • Augmentin (amoxicillin-clavulanate) is a type of antibiotic that can disrupt the normal balance of gut bacteria, which can increase the risk of C. diff infection 7.
  • However, the provided studies do not specifically investigate the relationship between Augmentin and C. diff infection.
  • The studies focus on the treatment and prevention of C. diff infection, and the use of alternative antibiotics such as vancomycin and fidaxomicin 4, 5, 6, 7.
  • It is known that the use of broad-spectrum antibiotics, including Augmentin, can increase the risk of C. diff infection, but the exact relationship between Augmentin and C. diff infection is not explicitly stated in the provided studies.

Treatment and Prevention of C. diff Infection

  • The treatment of C. diff infection typically involves the use of antibiotics such as vancomycin or fidaxomicin 4, 5, 6, 7.
  • Fecal microbiota transplantation is also a effective treatment for recurrent C. diff infection 5, 7.
  • The prevention of C. diff infection involves the use of antibiotic stewardship and infection control measures, as well as the use of validated risk prediction tools to identify patients at high risk of infection 7.
  • The use of alternative antibiotics such as fidaxomicin and bezlotoxumab may also be effective in preventing recurrent C. diff infection 5, 6, 7.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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