title: Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections.
abstract: Clostridium difficile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. Patients with CDI typically have extended lengths-of-stay in hospitals, and CDI is a frequent cause of large hospital outbreaks of disease. This guideline provides recommendations for the diagnosis and management of patients with CDI as well as for the prevention and control of outbreaks while supplementing previously published guidelines. New molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. We suggest treatment of patients be stratified depending on whether they have mild-to-moderate, severe, or complicated disease. Therapy with metronidazole remains the choice for mild-to-moderate disease but may not be adequate for patients with severe or complicated disease. We propose a classification of disease severity to guide therapy that is useful for clinicians. We review current treatment options for patients with recurrent CDI and recommendations for the control and prevention of outbreaks of CDI.
authors: Division of Gastroenterology, Department of Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA. surawicz@u.washington.edu
authors: Christina M
authors: CM
authors: Surawicz
authors: Lawrence J
authors: LJ
authors: Brandt
authors: David G
authors: DG
authors: Binion
authors: Ashwin N
authors: AN
authors: Ananthakrishnan
authors: Scott R
authors: SR
authors: Curry
authors: Peter H
authors: PH
authors: Gilligan
authors: Lynne V
authors: LV
authors: McFarland
authors: Mark
authors: M
authors: Mellow
authors: Brian S
authors: BS
authors: Zuckerbraun
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003428:Cross Infection / Q000517:prevention & control; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D006801:Humans; D007124:Immunoenzyme Techniques; D008795:Metronidazole / Q000627:therapeutic use; D017410:Practice Guidelines as Topic
chemical_list: D000890:Anti-Infective Agents; D008795:Metronidazole