TY - JOUR
T1 - Clostridium difficile infection
T2 - Current, forgotten and emerging treatment options
AU - Drekonja, Dimitri M.
PY - 2014/9/1
Y1 - 2014/9/1
N2 - Clostridium difficile infection (CDI) has increased in incidence and severity, and is now among the most common nosocomial infections. Several agents are available for the initial treatment of CDI, some of which are rarely used, and none of which is clearly superior for initial clinical cure. Fidaxomicin appears to offer a benefit in terms of preventing recurrent disease, although the cost-benefit ratio is debated. Recurrent CDI is a major challenge, occurring after 15-30% of initial episodes. The treatment of recurrent CDI is difficult, with sparse evidence available to support any particular agent. Fecal microbiota therapy, also known as 'stool transplantation', appears to be highly effective, although availability is currently limited, and the regulatory environment is in flux. Synthetic stool products and an orally available fecal microbiota therapy product are both under investigation, which may address the problem of availability. As with most infectious diseases, an effective vaccine would be a welcome addition to our armamentarium, but none is currently available.
AB - Clostridium difficile infection (CDI) has increased in incidence and severity, and is now among the most common nosocomial infections. Several agents are available for the initial treatment of CDI, some of which are rarely used, and none of which is clearly superior for initial clinical cure. Fidaxomicin appears to offer a benefit in terms of preventing recurrent disease, although the cost-benefit ratio is debated. Recurrent CDI is a major challenge, occurring after 15-30% of initial episodes. The treatment of recurrent CDI is difficult, with sparse evidence available to support any particular agent. Fecal microbiota therapy, also known as 'stool transplantation', appears to be highly effective, although availability is currently limited, and the regulatory environment is in flux. Synthetic stool products and an orally available fecal microbiota therapy product are both under investigation, which may address the problem of availability. As with most infectious diseases, an effective vaccine would be a welcome addition to our armamentarium, but none is currently available.
KW - Clostridium difficile infection
KW - fecal microbiota therapy
KW - fidaxomicin
KW - metronidazole
KW - vancomycin
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U2 - 10.2217/cer.14.36
DO - 10.2217/cer.14.36
M3 - Review article
C2 - 25350805
AN - SCOPUS:84908464532
VL - 3
SP - 547
EP - 557
JO - Journal of Comparative Effectiveness Research
JF - Journal of Comparative Effectiveness Research
SN - 2042-6305
IS - 5
ER -