title: Current strategies for management of initial Clostridium difficile infection.
abstract: In the past decade, an epidemic strain of Clostridium difficile has led to increased incidence and severity of nosocomial C. difficile infections (CDI). Responsiveness to standard antimicrobial care for this strain is declining, and the morbidity and mortality of CDI and recurrent CDI are rising. Effective management requires a coordinated effort among all members of the healthcare team to facilitate early identification of patients at risk for CDI, early recognition of disease onset and confirmatory testing, prompt initiation of the most appropriate management approach, and ongoing monitoring throughout the continuum of care. Hospitalists, as coordinators of patient care, are in an ideal position to ensure that patients receive prompt and optimal treatment based on current clinical evidence and severity of the disease.
authors.affiliation: Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. ckelly2@bidmc.harvard.edu
authors.forename: Ciarán P
authors.initials: CP
authors.lastname: Kelly
mesh_terms: D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D016360:Clostridioides difficile / Q000302:isolation & purification / Q000472:pathogenicity*; D003428:Cross Infection / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000382:microbiology; D003967:Diarrhea / Q000188:drug therapy / Q000382:microbiology; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis* / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D006801:Humans; D007422:Intestines / Q000187:drug effects / Q000382:microbiology; D007902:Length of Stay; D008795:Metronidazole / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D012047:Rehabilitation Centers; D012307:Risk Factors; D012720:Severity of Illness Index; D014640:Vancomycin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000900:Anti-Bacterial Agents; D008795:Metronidazole; D014640:Vancomycin