[The approach to recurrent infections with Clostridium difficile].

Clostridium difficile associated diarrhea is one of the most common nosocomial infections. This infection is solely induced by antibiotic treatment. The risk for this disease increased with the length of hospital admission, the specific type of antibiotic, the patient age and associated co-morbidities. Most patients respond to the antibiotic treatment with Vancomycin or Metronidazole. Unfortunately, in 15-25% of patients this disease will recur. The approach to recurrent and refractory disease requires creativity, combining antibiotics with other complementary methods. This includes: different combinations of antibiotic, anion binding resins, probiotics, fecal brachytherapy and IVIg.