Current treatment and epidemiology of Clostridium difficile infections

La Revue de médecine interne
A DinhA Le Monnier

Abstract

During the past 10years, Clostridium difficile infections (CDI) have become a major public health challenge. Their epidemiology has changed with a rise in the number of cases and an increase in severe episodes. Recurrence and failure of conventional treatments have become more common. Furthermore, a spread of CDI has been observed in the general population-involving subjects without the usual risk factors (unexposed to antibiotic treatment, young people, pregnant women, etc.). All these change are partially due to the emergence of the hypervirulent and hyperepidemic clone NAP1/B1/027. New therapeutic strategies (antimicrobial treatment, immunoglobulins, toxin chelation, fecal microbiota transplantation) are now available and conventional treatments (metronidazole and vancomycin) have been reevaluated with new recommendations. Recent studies show a better efficacy of vancomycin compared to metronidazole for severe episodes. Fidaxomicin is a novel antibiotic drug with interesting features, including an efficacy not inferior to vancomycin and a lower risk of recurrence. Finally, for multi-recurrent forms, fecal microbiota transplantation seems to be the best option. We present the available data in this review.

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Citations

May 31, 2016·Journal of Forensic and Legal Medicine·Cristian PalmiereDominique Werner
Jan 29, 2017·La Revue de médecine interne·P GarriguesA Mathieu
Jan 13, 2018·Obstetrics and Gynecology·Jacob Ruiter-LigetiHaim Arie Abenhaim

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