Managing Clostridium difficile in inflammatory bowel disease (IBD).
Clostridium difficile (C. difficile) infection has emerged as a significant clinical challenge for patients suffering from inflammatory bowel disease (IBD). C. difficile can both precipitate and worsen flares of IBD, contributing to emergent colectomies and mortality. Advances in the management of C. difficile infection in IBD include recommendations for testing for this infection in the setting of clinical flare and hospitalization, improved diagnostic testing, identification of high rates of carriage and infection in pediatric IBD, and new data associating patterns of IBD genetic risk alleles with the development of this infection. Therapeutically, oral vancomycin has emerged as a superior treatment for IBD patients with moderate to severe disease compared with metronidazole. Although highly effective in the general population, fecal microbiome transplantation for recurrent C. difficile infection in IBD patients has been associated with colitis flare in the majority of patients who have received this treatment.
Division of Gastroenterology, Hepatology and Nutrition, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, 200 Lothrop Street, Mezzanine Level C Wing PUH, Pittsburgh, PA, 15213, USA.
Jana G
JG
Hashash
David G
DG
Binion
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016360:Clostridioides difficile; D004761:Enterocolitis, Pseudomembranous / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005243:Feces / Q000382:microbiology; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000453:epidemiology; D009894:Opportunistic Infections / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D016378:Tissue Transplantation; D014640:Vancomycin / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D014640:Vancomycin