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Diarrhoea - antibiotic associated - Management
What test should I perform if a Clostridium difficile infection is suspected?

For adults and children 2 years of age and older with suspected Clostridium difficile infection:

  • Send a stool sample to test for C. difficile toxin if:
    • A clinical diagnosis of C. difficile infection is suspected, and
    • The person is symptomatic with liquid/loose stools (with a consistency that takes the shape of the container).
  • Ensure the following details are stated on the request form:
    • Clinical features (for example: systemic illness; fever; bloody stool; abdominal pain; immunosuppression; and onset, duration and recurrence of symptoms).
    • Recent antibiotic or proton pump inhibitor, or hospital admission.
    • Contact with other affected individuals or outbreak.
    • State whether the test was requested by the Health Protection Unit or a Consultant in Communicable Disease Control.
  • Re-test after 24 hours only if the first test is negative and there is a strong clinical suspicion of C. difficile infection.
  • Do not re-test people with positive C. difficile infection if the person is still symptomatic within a period of 28 days.
  • Only re-test to confirm recurrent C. difficile infection if the symptoms resolve and then recur.
  • For more information on how to advise the person to take a stool sample, see the section on Collection of stool samples in the CKS topic on Gastroenteritis.

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