C. Difficile Diarrhea: Prevention & Treatment

Updated: 3/28/31

Clostridium Difficile (C. diff) in Lyme Disease Diarrhea

Clostridium difficile (C. diff) overgrowth in the intestines causes diarrhea. This is a bacterium, which lives in our intestines and can grow too much when a person is on prescription antibiotics. Here are the steps to treat and prevent this condition.

C. diff normally lives in the intestines in balance with the other intestinal organisms. However, some antibiotics result in the germ becoming excessive. In excess it releases a toxin that leads to severe diarrhea and abdominal cramping. There is a stool test for the toxin to determine if a person has this infection.

When C. diff is present, stop Lyme antimicrobials and start one for C. diff. Saccharomyces boulardii (Sacro B) is a beneficial yeast that lives in the intestines that can help treat and prevent C. diff. When antibiotics fail, an alternative treatment to C. diff uses a stool transplant from a healthy donor, which is called a fecal microbiota transplant. More recently, for those with recurrent C. diff diarrhea, bezlotoxumab infusion (a monoclonal antibody against the C. difficile toxin) is recommended in addition to using antibiotics.

C. Difficile Prevention in Lyme Disease

You can help prevent C. diff by taking probiotics. This is very important in someone who has a history of C. diff diarrhea. In this type of situation, Sacro B is very effective at preventing another episode of C. diff.

• Probiotics. Start at 2 pills 1 time a day. In my practice, I recommend Multi-Biome by Researched Nutritionals which contains human and soil-based strains. When diarrhea is present, double the dose to 2 pills 2 times a day. Be sure to take it as far away from antibiotics as possible.
• Saccharomyces boulardii (Sacro B). Start at 4 pills 1 time a day for active diarrhea. Once you have had a C. diff infection, you should remain on this at 4 pills 1 time a day while you are on herbal or prescription antibiotics for Lyme to prevent C. diff from causing diarrhea again.

C. Difficile Treatment in Lyme Disease

When diarrhea occurs due to C. diff, herbal and prescription antibiotics for Lyme and the co-infections must be stopped. There are three antibiotics that treat C. diff infection to resolve the diarrhea. Use vancomycin or fidaxomicin first. If they do not work, then consider metronidazole. While metronidazole is much cheaper than the other antibiotics, it is much less effective and has more potential for side effects. In addition, use an effective probiotic and Sacro B.

Antibiotics

• Vancomycin 125 mg 1 pill 4 times a day for 10 days.
• Fidaxomicin 200 mg 1 pill 1 time a day for 10 days.
• Metronidazole 500 mg 1 pill 3 times a day for 10 days.

Probiotics

• Probiotics. Start at 2 pills 1 time a day. In my practice, I recommend Multi-Biome by Researched Nutritionals, which contains human and soil-based strains. When diarrhea is present, double the dose to 2 pills 2 times a day. Be sure to take it as far away from antibiotics as possible.
• Saccharomyces boulardii (Sacro B). Start at 4 pills 1 time a day for active diarrhea. Once you have had a C. diff infection, you should remain on this at 4 pills 1 time a day while you are on herbal or prescription antibiotics.

Fecal Microbiota Transplant

This is a very effective way to treat C. diff if one or two rounds of antibiotics do not work. Studies show it works about 90 percent of the time. It can be administered in a physician’s office or the home by enema. Another option is to take 30-40 freeze dried pills a day for about 10 days.

Bezlotoxumab

If there is a recurrence of C. diff after initial antibiotics, then adding bezlotoxumab to the next antibiotic treatment may help to prevent further relapses. Bezlotoxumab is a monoclonal antibody against the C. difficile toxin.

• Bezlotoxumab 10mg/kg IV 1 time.

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