Treatment strategies for recurrent and refractory Clostridium difficile-associated diarrhea

Abstract

Clostridium difficile, the most common nosocomial infection of the GI tract, has become a bigger threat with the emergence of a hypervirulent strain. C. difficile-associated diarrhea (CDAD) is usually a consequence of antibiotic therapy or chemotherapy, but sporadic cases occur, and an increase in severe sporadic cases is of great concern. Epidemics of CDAD with high morbidity and mortality have been documented in the USA, Canada and Europe, making accurate diagnosis, effective therapy and strategies for prevention more important than ever. Treatment of refractory and recurrent CDAD remain therapeutic challenges. Improved treatments are needed; several new drugs are currently in trials.

Keywords::

• metronidazole
• recurrent Clostridium difficile-associated diarrhea
• refractory Clostridium difficile-associated diarrhea
• Saccharomyces boulardii
• treatment strategies
• vancomycin

Financial & competing interests disclosure

Christina Surawicz has received honoraria for speaking engagements from the Robert Michaels Institute (for Viropharma) and Biocodex, Inc. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.