Management of Recurrent Clostridium difficile Infection in a 75-Year-Old Woman with Multiple Comorbidities and Marked Anxiety Using a Combined Therapeutic Approach

This case report discusses the successful management of a 75-year-old woman with recurrent Clostridiumdifficile infection (rCDI), complicated by multiple comorbidities including cardiovascular disease, diabetes,and marked anxiety. The treatment included butyrate supplementation, probiotic therapy with Clostridium butyricum CBM588®, and low-dose amitriptyline to address both the gastrointestinal and psychological components of her condition. The combination therapy resulted in a significant reduction in gastrointestinal symptoms, prevention of further CDI recurrences, and improved mentalwell-being. The discussion highlights how restoring the gut microbiota positively impacts the reduction of inflammation, intestinal permeability, andthe gut-brain axis, as well as the importance of a multidisciplinary approach in rCDI. Further research is recommended to validate the efficacy of these therapies in broader populations.