Novel therapies for severe Clostridium difficile colitis

Current Opinion in Critical Care
Paul Waltz, Brian S Zuckerbraun

Abstract

Clostridium difficile infection (CDI) is becoming a large healthcare burden with increasing incidence, high recurrence rates, and associated morbidity and mortality. Disease severity varies from mild to severe and complicated presentations. Current mainstays of therapy in severe CDI include: fluid resuscitation, support of organ dysfunction, discontinuation of inciting agents, and antibiotic treatment. Recent focus on the impact of the microbiome and targeted therapies to reconstitute biodiversity may provide alternative therapeutic modalities with higher success and lower recurrence rates. Newer antibiotics are under development, along with targeted immunotherapies that attempt to neutralize pathogenic toxins. Alternative surgical options from traditional subtotal colectomy may provide a less morbid surgical option for those requiring intervention. With further understanding of the pathogenesis and shortcomings of current therapies, the future of management of CDI may include a multimodal approach focusing on microbiota and immunologic therapies that could result in improved cure with reduced recurrence.

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Citations

Aug 2, 2017·BMJ Open·Greig McCreeryUNKNOWN ERASE C. difficile (Early Rescue from Acute SEvere Clostridium difficile) Trials Group

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Methods Mentioned

BETA
lavage

Clinical Trials Mentioned

NCT01987895
NCT01597505

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