Treatment of Clostridioides (Clostridium) difficile infection.

Treatment of Clostridioides (Clostridium) difficile infection. Ann Med. 2019 Dec 05;:1-17 Authors: Oksi J, Anttila VJ, Mattila E Abstract Clostridioides (formerly: Clostridium) difficile infection (CDI) is a major cause of diarrhea for inpatients as well as outpatients. Usually, CDI is healthcare-associated but the number of community-acquired infections is increasing. CDI is generally associated with changes in the normal intestinal microbiota caused by administration of antibiotics. Elderly and immunocompromised patients are at greater risk for CDI and CDI recurrence. Recently, the treatment options of CDI have undergone major changes: current recommendations speak against using metronidazole for primary CDI, fidaxomicin and bezlotoxumab have been added to the treatment armamentarium and microbial replacement therapies have emerged. Several other therapies are undergoing clinical trials. In this paper we review current treatment guidelines, present the most recent data on the options to treat CDI and glance toward future developments. Key messages:The cornerstones for the treatment of CDI are vancomycin and fidaxomicin. Metronidazole should be used only in mild-to-moderate disease in younger patients who have no or only few risk factors for recurrence.In recurrent CDI, bezlotoxumab infusion (a monoclonal antibody against C. difficile toxin B) may be considered as an adjunctive therapeutic strategy in addition to the standard care p...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research