RISK OF DIARRHEA, CLOSTRIDIUM-DIFFICILE AND CEFOTAXIME IN THE ELDERLY

Clostridium difficile diarrhoea is an increasingly important nosocomia l infection. Clostridium difficile infection is associated with antibi otic use. The elderly are at greatest risk. We reported an outbreak as sociated with the use of cefotaxime, a third-generation cephalosporin. We review the extent of this association, putative causal mechanisms and suggest an integrated approach to the control of C difficile infec tion which focusses on both limiting environmental contamination and r educing patient susceptibility. Future developments are also considere d, especially the potential for vaccination.