Update on Management of Clostridium difficile Infection

Clostridium difficile infection (CDI) is a major cause of morbidity and mortality, both in hospitalized patients and in the community. Despite the importance of CDI, therapeutic options remain limited. The Society for Hospital Epidemiology of America and the Infectious Diseases Society of America published guidelines for CDI management in 2010. Recommendations based on randomized controlled trial data include metronidazole or oral vancomycin for mild to moderate disease and oral vancomycin for severe disease. Since publication of these guidelines, fidaxomicin has been approved based on trials showing similar clinical cure rates and a lower recurrence rate compared to oral vancomycin. Patients with fulminant, complicated, or multiply recurrent disease have not been included in controlled trials, so therapeutic decisions are supported by observational or anecdotal studies. Epidemiologic studies consistently identify systemic antibiotic use as a major risk factor for development of CDI. This risk tends to in...

[1]  P. Thompson,et al.  Clinical and economic outcomes of a prospective antimicrobial stewardship program. , 2012, American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists.

[2]  Spencer E. Harpe,et al.  Characterization of Continued Antibacterial Therapy After Diagnosis of Hospital‐Onset Clostridium difficile Infection: Implications for Antimicrobial Stewardship , 2012, Pharmacotherapy.

[3]  Stuart Johnson,et al.  Current State of Clostridium difficile Treatment Options , 2012, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[4]  T. Louie,et al.  Fidaxomicin Preserves the Intestinal Microbiome During and After Treatment of Clostridium difficile Infection (CDI) and Reduces Both Toxin Reexpression and Recurrence of CDI , 2012, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[5]  R. Murray,et al.  Point‐prevalence study of inappropriate antibiotic use at a tertiary Australian hospital , 2012, Internal medicine journal.

[6]  Matthew H Samore,et al.  Double trouble: how big a problem is redundant anaerobic antibiotic coverage in Veterans Affairs medical centres? , 2012, The Journal of antimicrobial chemotherapy.

[7]  D. Crook,et al.  Fidaxomicin versus vancomycin for infection with Clostridium difficile in Europe, Canada, and the USA: a double-blind, non-inferiority, randomised controlled trial. , 2012, The Lancet. Infectious diseases.

[8]  A. Rachlis,et al.  Audit and Feedback to Reduce Broad-Spectrum Antibiotic Use among Intensive Care Unit Patients A Controlled Interrupted Time Series Analysis , 2012, Infection Control & Hospital Epidemiology.

[9]  O. Dekkers,et al.  Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. , 2012, The Journal of antimicrobial chemotherapy.

[10]  A. Zinsmeister,et al.  The Epidemiology of Community-Acquired Clostridium difficile Infection: A Population-Based Study , 2012, The American Journal of Gastroenterology.

[11]  K. Garey,et al.  A randomized, double-blind, placebo-controlled pilot study to assess the ability of rifaximin to prevent recurrent diarrhoea in patients with Clostridium difficile infection. , 2011, The Journal of antimicrobial chemotherapy.

[12]  V. Leung,et al.  Growing a "positive culture" of antimicrobial stewardship in a community hospital. , 2011, The Canadian journal of hospital pharmacy.

[13]  Mark A. Miller,et al.  Efficacy of Fidaxomicin Versus Vancomycin as Therapy for Clostridium difficile Infection in Individuals Taking Concomitant Antibiotics for Other Concurrent Infections , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[14]  G. Dumyati,et al.  Cumulative antibiotic exposures over time and the risk of Clostridium difficile infection. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[15]  Linda M. Spooner,et al.  Tigecycline for the Treatment of Severe Clostridium difficile Infection , 2011, The Annals of pharmacotherapy.

[16]  David L Paterson,et al.  Strategies for reduction in duration of antibiotic use in hospitalized patients. , 2011, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[17]  Pamela Sears,et al.  Fidaxomicin versus vancomycin for Clostridium difficile infection. , 2011, The New England journal of medicine.

[18]  E. Ashley,et al.  Alternative Therapies for Clostridium difficile Infections , 2010, Pharmacotherapy.

[19]  D. Gerding,et al.  Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA) , 2010, Infection Control & Hospital Epidemiology.

[20]  Linda M. Spooner,et al.  Fidaxomicin: A Macrocyclic Antibiotic for the Management of Clostridium difficile Infection , 2010, The Annals of pharmacotherapy.

[21]  T. Welte,et al.  Intravenous tigecycline as adjunctive or alternative therapy for severe refractory Clostridium difficile infection. , 2009, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[22]  J. Blondeau.  What have we learned about antimicrobial use and the risks for Clostridium difficile-associated diarrhoea? , 2008, The Journal of antimicrobial chemotherapy.

[23]  K. Garey,et al.  Rifamycin Antibiotics for Treatment of Clostridium difficile–Associated Diarrhea , 2008, The Annals of pharmacotherapy.

[24]  Carlene A. Muto,et al.  Antimicrobial-associated risk factors for Clostridium difficile infection. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[25]  Melinda B Davis,et al.  A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[26]  D. Gerding,et al.  Interruption of recurrent Clostridium difficile-associated diarrhea episodes by serial therapy with vancomycin and rifaximin. , 2007, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[27]  C. Rees,et al.  Intravenous Immunoglobulin for the Treatment of Severe, Refractory, and Recurrent Clostridium difficile Diarrhea , 2006, Diseases of the colon and rectum.

[28]  S. Routhier,et al.  Management and outcomes of a first recurrence of Clostridium difficile-associated disease in Quebec, Canada. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[29]  H. Dupont,et al.  Rifaximin: a novel nonabsorbed rifamycin for gastrointestinal disorders. , 2006, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[30]  F. Friedenberg,et al.  Continuation of Antibiotics Is Associated With Failure of Metronidazole for Clostridium difficile-Associated Diarrhea , 2006, Journal of clinical gastroenterology.

[31]  M. Wilcox.  Descriptive study of intravenous immunoglobulin for the treatment of recurrent Clostridium difficile diarrhoea. , 2004, The Journal of antimicrobial chemotherapy.

[32]  Norma Terrin,et al.  Favorable Impact of a Multidisciplinary Antibiotic Management Program Conducted During 7 Years , 2003, Infection Control & Hospital Epidemiology.

[33]  Mary F. Wisniewski,et al.  Antibiotic combinations with redundant antimicrobial spectra: clinical epidemiology and pilot intervention of computer-assisted surveillance. , 2003, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[34]  M. Stevenson,et al.  Antibiotics and hospital-acquired Clostridium difficile-associated diarrhoea: a systematic review. , 2003, The Journal of antimicrobial chemotherapy.

[35]  A. Apisarnthanarak,et al.  Adjunctive intracolonic vancomycin for severe Clostridium difficile colitis: case series and review of the literature. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[36]  E. Mylonakis,et al.  Clostridium difficile--Associated diarrhea: A review. , 2001, Archives of internal medicine.

[37]  C. Kelly,et al.  Association between antibody response to toxin A and protection against recurrent Clostridium difficile diarrhoea , 2001, The Lancet.

[38]  G E Bignardi,et al.  Risk factors for Clostridium difficile infection. , 1998, The Journal of hospital infection.

[39]  D. Gerding,et al.  Clostridium difficile--associated diarrhea. , 1998, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[40]  W. Graninger,et al.  Comparison of vancomycin, teicoplanin, metronidazole, and fusidic acid for the treatment of Clostridium difficile-associated diarrhea. , 1996, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[41]  D. Gordon,et al.  Approach to patients with multiple relapses of antibiotic-associated pseudomembranous colitis. , 1985, The American journal of gastroenterology.

[42]  D. Gerding,et al.  PROSPECTIVE RANDOMISED TRIAL OF METRONIDAZOLE VERSUS VANCOMYCIN FOR CLOSTRIDIUM-DIFFICILE-ASSOCIATED DIARRHOEA AND COLITIS , 1983, The Lancet.