title: Australasian Society for Infectious Diseases guidelines for the diagnosis and treatment of Clostridium difficile infection.
abstract: Clostridium difficile is the most common cause of health care-associated and antibiotic-associated diarrhoea. These guidelines are intended to provide advice to clinicians on the clinical assessment, diagnosis and management of C. difficile infection (CDI). Hypervirulent strains of C. difficile, including PCR ribotype 027 strains recently identified in Australia, have been associated elsewhere with epidemic spread and high rates of severe disease and death. Diagnostic tests include stool culture, polymerase chain reaction-based assays, cell-culture cytotoxicity assays and enzyme immunoassays detecting C. difficile glutamate dehydrogenase, and/or toxin A and/or B. To treat an initial episode and a first recurrence, metronidazole is the preferred antibiotic, with oral vancomycin reserved for severe disease and subsequent recurrences. Surgery should be considered for fulminant disease.
authors.affiliation: Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia. allen.cheng@monash.edu
authors.forename: Allen C
authors.initials: AC
authors.lastname: Cheng
authors.forename: John K
authors.initials: JK
authors.lastname: Ferguson
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Richards
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Robson
authors.forename: Gwendolyn L
authors.initials: GL
authors.lastname: Gilbert
authors.forename: Alistair
authors.initials: A
authors.lastname: McGregor
authors.forename: Sally
authors.initials: S
authors.lastname: Roberts
authors.forename: Tony M
authors.initials: TM
authors.lastname: Korman
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Riley
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001315:Australia; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D006801:Humans; D009520:New Zealand; D019936:Probiotics / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents