Antibiotics are perhaps one of the greatest public health discoveries in human history, saving millions of lives and improving the quality of life of countless people. However, the excessive and oftentimes irresponsible use of antibiotics has also had some serious negative consequences, most notably the development of antibiotic resistant species, especially Methicillin-resistant Staphylococcus aureus (MRSA). MRSA is a form of Staphylococcus aureus that has developed resistance to the most common forms of antibiotics, including penicillins and cephalosporins.

Researchers are beginning to see that another problematic bacteria is also increasing in prominence as a result of excessive antibiotic use: Clostridium difficile. C. difficile can lead to mild and sometimes severe diarrhea. If it gets into the bloodstream, it can be life threatening. In the past, C. difficile was mostly seen in nursing homes and hospitals, but has become increasingly common in otherwise healthy people, particularly those taking antibiotics.

In small numbers, C. difficile can exist in our intestines with no adverse consequences. When a person takes certain antibiotics, however, the destruction of the normal gut flora can create a situation where C. difficile, in the absence of competition, can now flourish and take off, thus making antibiotics a risk factor.

Adding to the problem is the advent of a new strain of the bug. Normally the bacteria produces a toxin that can destroy the lining of the colon, but the new "hypervirulent" strain makes as much as 20 to 30 times more of the toxin. It is therefore associated with more severe diseases, and may at time require surgery.

The situation is complicated by the fact that infection with C. difficile often appears as a common bacterial infection, which is usually treated with antibiotics. When therapy is initiated, it can potentially exacerbate the problem by allowing the it to thrive. Once C. difficile takes hold, other antibiotics are needed to combat it. Furthermore, current testing for C. difficile can take up to three days before results are obtained.

For now, the best course of action is prevention through proper and vigilant hygiene, especially in a hospital or health care setting. Standard treatment for mild cases of C. difficile have not changed, but in situations involving the hypervirulent strain, more aggressive intervention may be required.

C. difficile infection is still relatively uncommon in healthy people, though it is becoming increasingly common in hospital settings and in the elderly. If you have questions or concerns, speak with your physician. For more information, visit the website for the Center for Disease Control and Prevention (CDC).