title: Current state of Clostridium difficile treatment options.
abstract: Recent reports of reduced response to standard therapies for Clostridium difficile infection (CDI) and the risk for recurrent CDI that is common with all currently available treatment agents have posed a significant challenge to clinicians. Current recommendations include metronidazole for treatment of mild to moderate CDI and vancomycin for severe CDI. Results from small clinical trials suggest that nitazoxanide and teicoplanin may be alternative options to standard therapies, whereas rifaximin has demonstrated success in uncontrolled trials for the management of multiple recurrences. Anecdotal reports have also suggested that tigecycline might be useful as an adjunctive agent for the treatment of severe complicated CDI. Reports of resistance will likely limit the clinical use of fusidic acid and bacitracin and, possibly, rifaximin if resistance to this agent becomes widespread. Treatment of patients with multiple CDI recurrences and those with severe complicated CDI is based on limited clinical evidence, and new treatments or strategies are needed.
authors: St John Hospital and Medical Center and Wayne State University School of Medicine, Detroit, Michigan, USA.
authors: Anilrudh A
authors: AA
authors: Venugopal
authors: Stuart
authors: S
authors: Johnson
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001414:Bacitracin / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D016360:Clostridioides difficile / Q000187:drug effects / Q000472:pathogenicity*; D003015:Clostridium Infections / Q000188:drug therapy* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D005672:Fusidic Acid / Q000627:therapeutic use; D006801:Humans; D008795:Metronidazole / Q000627:therapeutic use; D009574:Nitro Compounds; D055502:Secondary Prevention; D012720:Severity of Illness Index; D017334:Teicoplanin / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use; D016896:Treatment Outcome; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D009574:Nitro Compounds; D013844:Thiazoles; D001414:Bacitracin; D008795:Metronidazole; D005672:Fusidic Acid; D017334:Teicoplanin; D014640:Vancomycin; C041747:nitazoxanide