UMEM Educational Pearls

Clostridium Difficile Associated Diarrhea and The Elderly Patient

  • Infectious diseases remain the leading cause of mortality in the elderly.
  • An infection that is increasing in prevlance among elderly patients is Clostridium difficile-associated diarrhea (CDAD).
  • Mortality rates are up to 3.5 times higher in elderly patients with CDAD compared to younger patients.
  • Antimicrobial therapy within the previous 6 weeks is the strongest risk factor for CDAD.
  • Though any antibiotic may cause CDAD, clindamycin, fluoroquinolones, and cephalosporins have the highest risk.
  • Importantly, the diarrhea may not always bloody.
  • Metronidazole remains the treatment of choice for uncomplicated infections.


Heppner HJ, et al. Infections in the Elderly. Crit Care Clin 2013; 29:757-774.