Antimicrobial therapy of Clostridium difficile-associated diarrhea.
Clostridium difficile-associated diarrhea (CDAD) is the most common etiologically-defined cause of hospital-acquired diarrhea. Caused by the toxins of certain strains of C difficile, CDAD represents a growing concern, with epidemic outbreaks in some hospitals where very aggressive and difficult-to-treat strains have recently been found. Incidence of CDAD varies ordinarily between 1 to 10 in every 1,000 admissions. Evidence shows that CDAD increases morbidity, length of stay, and costs. This article described the clinical manifestations of CDAD, related risk factors, considerations for confirming CDAD, antimicrobial and non-antimicrobial treatment of CDAD, and issues related to relapses. The article concludes with a discussion of recent epidemic outbreaks involving CDAD.
Bouza
Emilio
E
Department of Clinical Microbiology and Infectious Diseases, Hospital General Universitario Gregorio Marañón, Universidad Complutense, Dr. Esquerdo 46, 28007 Madrid, Spain.
Burillo
Almudena
A
Muñoz
Patricia
P
D000368:Aged; D000890:Anti-Infective Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001426:Bacterial Proteins / Q000032:analysis; D001427:Bacterial Toxins / Q000032:analysis; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000188:drug therapy* / Q000209:etiology / Q000276:immunology; D003428:Cross Infection / Q000188:drug therapy / Q000209:etiology; D003967:Diarrhea / Q000188:drug therapy* / Q000276:immunology; D004196:Disease Outbreaks; D005243:Feces / Q000737:chemistry; D006801:Humans; D007223:Infant; D008532:Megacolon, Toxic / Q000517:prevention & control; D008795:Metronidazole / Q000627:therapeutic use; D009574:Nitro Compounds; D012307:Risk Factors; D055502:Secondary Prevention; D013844:Thiazoles / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
D000890:Anti-Infective Agents; D001426:Bacterial Proteins; D001427:Bacterial Toxins; D009574:Nitro Compounds; D013844:Thiazoles; C031815:toxB protein, Clostridium difficile; D008795:Metronidazole; D014640:Vancomycin; C041747:nitazoxanide