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 provided to patients wi...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research

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CONCLUSION: FMT seems to be a promising and safe therapy in the management of UC. Further research, with larger cohorts, will be needed to confirm this and to determine the optimal FMT procedure. PMID: 31950808 [PubMed - in process]
Source: Acta Gastro-Enterologica Belgica - Category: Gastroenterology Tags: Acta Gastroenterol Belg Source Type: research
AbstractClostridioides difficile (formerlyClostridium difficile) infection (CDI) represents a worrisome condition, often underestimated, with severe clinical presentations, frequently requiring intensive care unit (ICU) admission. The aim of the present expert statement was to give an overview of the management of CDI in critically ill patients, for whom CDI represents a redoubtable problem, in large part related to the use and abuse of antibiotics. The available knowledge about pathophysiology, risk factors, diagnosis and treatment concerning critical care patients affected by CDI has been reviewed, even though most of th...
Source: Intensive Care Medicine - Category: Intensive Care Source Type: research
Conclusions. CDI is more prevalent in children after ITx compared with other organ Tx; it is most often symptomatic but mildly or moderately severe. Standard antibiotics efficiently control the symptoms. Induction of rejection is a rare event.
Source: Transplantation - Category: Transplant Surgery Tags: Original Clinical Science—General Source Type: research
Fecal microbiota transplant has been shown to be very effective in treating recurrent or refractory C. difficile infection. Is it beneficial in severe and fulminant C. difficile infection as well?Alimentary Pharmacology &Therapeutics
Source: Medscape Critical Care Headlines - Category: Intensive Care Tags: Gastroenterology Journal Article Source Type: news
Abstract Clostridium difficile infection (CDI) is featured as the dysbiosis of gut microbiota and consequent mild diarrhoea or severe pseudomembranous colitis. However, the frequent recurrence of CDI following treatment course challenged the antibiotic therapy. Currently, to address the relapse of CDI, several novel therapeutic approaches have emerged, including Bezlotoxumab, SYN-004 (Ribaxamase), RBX2660, and faecal microbial transplant. Traditional Chinese Medicine (TCM) is an old medical system accumulated for thousands of years. Orientated by syndrome-based treatment, TCM functions in a multicomponent and mult...
Source: Critical Reviews in Microbiology - Category: Microbiology Authors: Tags: Crit Rev Microbiol Source Type: research
Clostridioides difficile infection (CDI) is increasing morbidity and mortality rates globally. Fecal microbiota transplantation (FMT), an effective therapy for eliminating Clostridioides difficile (C. difficile), cannot be used extensive due to a range of challenges. Probiotics thus constitutes a promising alternative therapy. In our study, we evaluated the effect of consortium of probiotics including five Lactobacilli strains and two Bifidobacterium strains on the colonization of toxigenic BI/NAP1/027 C. difficile in a mouse model. The results of 16S rRNA sequencing and targeted metabolomics showed the consortium of probi...
Source: Frontiers in Microbiology - Category: Microbiology Source Type: research
Purpose of review The association between dysbiosis and CKD is well established. This review focuses on the current understanding of microbiome, in normal individuals and CKD patients, in order to hypothesize how to correct uremic toxins levels and preserve the renal function and reduce associated comorbidities. Here we discuss our current opinion on microbiome modulation in order to manage the CKD-associated dysbiosis. Recent findings Emerging evidence confirms the role of gut microbiome in the progression of CKD. In this scenario, the need is felt to set up multifaceted approaches for dysbiosis management. Among man...
Source: Current Opinion in Nephrology and Hypertension - Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Kamyar Kalantar-Zadeh and Ekamol Tantisattamo Source Type: research
Conclusions Clostridium difficile infection has an incidence rate of 9.4% in HSCT recipients. Established risk factors including age, sex, cancer type, and transplant type were not identified as risk factors in our population. However, longer LOS and use of more than 4 lines of antibiotics were observed among those with CDI compared with those without CDI.
Source: Infectious Diseases in Clinical Practice - Category: Infectious Diseases Tags: Original Articles Source Type: research
The gastro-intestinal tract is an extensive organ involved in several activities, with a crucial role in immunity. Billions of commensal and transient microorganisms, known as the gut microbiota, and potential pathogens, which are constantly stimulating intestinal immunity, colonize the intestinal epithelial surface. The gut microbiota may be regarded as analogous to a solid organ with multiple different functions. In the last decade, many studies have demonstrated that intestinal bacteria can be a decisive factor in the health-disease balance of the intestine, and they can also be responsible for illnesses in other locati...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
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Source: European Journal of Gastroenterology and Hepatology - Category: Gastroenterology Tags: Letters to the Editor Source Type: research
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