Future novel therapeutic agents for Clostridium difficile infection.
BACKGROUND
Clostridium difficile is the most important definable cause of healthcare acquired diarrhea. The increasing incidence and mortality associated with this enteric pathogen and the significant rate of treatment failures and recurrences with current antibiotics emphasize the need for the discovery of new and improved therapeutic and preventative agents.


RESULTS
We review upcoming novel therapeutic agents and the clinical evidence to support their efficacy in treating C. difficile infection. We also provide an extensive comparison of antimicrobial susceptibilities of C. difficile based on in vitro susceptibilities published in the literature.


METHODS
This review was conducted by a thorough examination of the public sources, including journals and scientific meeting abstracts, up to February 2009.


CONCLUSIONS
A number of new therapeutic agents are in development and being tested in clinical trials. However, high costs and concerns for resistance may limit the use of these antimicrobials for the treatment of C. difficile infection. Passive and active immunotherapy may have important future roles as therapeutic and preventative strategies for C. difficile infection.
Baylor College of Medicine, Internal Medicine, Houston, TX 77030, USA. koo@bcm.tmc.edu
Hoonmo L
HL
Koo
Kevin W
KW
Garey
Herbert L
HL
Dupont
D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D016360:Clostridioides difficile / Q000187:drug effects* / Q000302:isolation & purification; D024881:Drug Resistance, Bacterial; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy* / Q000382:microbiology / Q000517:prevention & control; D006801:Humans; D007116:Immunization, Passive; D016233:Immunotherapy, Active; D019936:Probiotics / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents