The changing face of Clostridium difficile: what treatment options remain?
In this issue of the Journal, an article by Pepin et al. documents the shifting sands of the modern-day Clostridium difficile epidemic as seen in Quebec. Pepin and coauthors' observation that the superior activity of vancomycin over metronidazole has been lost since the emergence there of the hypervirulent strain NAP1/027 in 2003 has implications for the future treatment of C. difficile-associated diarrhea (CDAD). This editorial explores these, particularly in complicated cases and high-risk populations.
Shen
Edie P
EP
Surawicz
Christina M
CM
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile / Q000302:isolation & purification / Q000472:pathogenicity*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology* / Q000517:prevention & control; D005260:Female; D006801:Humans; D008297:Male; D008795:Metronidazole / Q000627:therapeutic use*; D011792:Quebec / Q000453:epidemiology; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use*
D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin