Epidemiology, diagnosis and treatment of Clostridium difficile infection.
Expert Rev Anti Infect Ther
; 10(12): 1405-23, 2012 Dec.
Article
en En
| MEDLINE
| ID: mdl-23253319
ABSTRACT
Clostridium difficile infection (CDI) is considered to be the main cause of bacterial infectious diarrhea in nosocomial settings. Since the beginning of the new century a continuous rise in the incidence of severe CDI has been observed worldwide. Even though some CDI cases are not associated with previous antibiotic exposure, this remains as the principal risk factor for the development of CDI. The rate of recurrences represents perhaps one the most challenging aspect on the management of CDI. There are several microbiological tests available, but glutamate dehydrogenase antigen test can be selected as the first screening step in a diagnostic algorithm, with positive samples then confirmed using a toxin(s) test, to distinguish toxinogenic from nontoxinogenic CDI. Although metronidazole and vancomycin are and have been the mainstay treatment options for CDI, there are some unmet medical and therapeutical needs. Usually oral metronidazole is recommended for initial treatment of nonsevere CDI and vancomycin for treatment of severe disease. Fidaxomicin may be considered in patients who cannot tolerate vancomycin, although more data are needed. For treatment of a nonsevere initial recurrence of CDI, oral metronidazole should be used, but for treatment of subsequent recurrences or more severe cases fidaxomicin may be helpful.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Enterocolitis Seudomembranosa
/
Clostridioides difficile
/
Antibacterianos
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Humans
Idioma:
En
Revista:
Expert Rev Anti Infect Ther
Asunto de la revista:
DOENCAS TRANSMISSIVEIS
Año:
2012
Tipo del documento:
Article
País de afiliación:
Italia