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Management of adult Clostridium difficile digestive contaminations: a literature review.

Authors :
Mathias F
Curti C
Montana M
Bornet C
Vanelle P
Source :
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology [Eur J Clin Microbiol Infect Dis] 2019 Feb; Vol. 38 (2), pp. 209-231. Date of Electronic Publication: 2018 Nov 29.
Publication Year :
2019

Abstract

Clostridium difficile infections (CDI) dramatically increased during the last decade and cause a major public health problem. Current treatments are limited by the high disease recurrence rate, severity of clinical forms, disruption of the gut microbiota, and colonization by vancomycin-resistant enterococci (VRE). In this review, we resumed current treatment options from official recommendation to promising alternatives available in the management of adult CDI, with regard to severity and recurring or non-recurring character of the infection. Vancomycin remains the first-line antibiotic in the management of mild to severe CDI. The use of metronidazole is discussed following the latest US recommendations that replaced it by fidaxomicin as first-line treatment of an initial episode of non-severe CDI. Fidaxomicin, the most recent antibiotic approved for CDI in adults, has several advantages compared to vancomycin and metronidazole, but its efficacy seems limited in cases of multiple recurrences. Innovative therapies such as fecal microbiota transplantation (FMT) and antitoxin antibodies were developed to limit the occurrence of recurrence of CDI. Research is therefore very active, and new antibiotics are being studied as surotomycin, cadazolid, and rinidazole.

Details

Language :
English
ISSN :
1435-4373
Volume :
38
Issue :
2
Database :
MEDLINE
Journal :
European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology
Publication Type :
Academic Journal
Accession number :
30498879
Full Text :
https://doi.org/10.1007/s10096-018-3419-z