title: Challenges and opportunities in the management of Clostridium difficile infection.
abstract: Clostridium difficile infection (CDI) is increasing in all regions of the world where sought. There is no gold standard for diagnosis of CDI, with available tests having limitations. Prevention of CDI will be seen with antibiotic stewardship, improved disinfection of hospitals and nursing homes, chemo- and immuno-prophylaxis and next generation probiotics. The important therapeutic agents are oral vancomycin and fidaxomicin with metronidazole being used only in mild cases or when oral therapy cannot be given. Current therapy of CDI for 10 days is associated with high rate of recurrence that may be prevented by prolonging initial therapy. Future treatment strategies will focus on drugs that inhibit C. difficile, reduce toxin activity and inflammation in the gut, and improve colonic flora diversity.
authors.affiliation: University of Texas School of Public Health, Baylor St. Luke's Medical Center, Baylor College of Medicine, Kelsey Research Foundation, 1200 Herman Pressler St., Suite 733, Houston, TX 77030, USA.
authors.forename: Herbert L
authors.initials: HL
authors.lastname: DuPont
mesh_terms: D000617:Aminoglycosides / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile; D003015:Clostridium Infections / Q000175:diagnosis* / Q000628:therapy*; D000077732:Fidaxomicin; D006801:Humans; D007155:Immunologic Factors / Q000627:therapeutic use; D008795:Metronidazole / Q000627:therapeutic use; D019936:Probiotics / Q000627:therapeutic use; D014640:Vancomycin / Q000627:therapeutic use
chemical_list: D000617:Aminoglycosides; D000900:Anti-Bacterial Agents; D007155:Immunologic Factors; D008795:Metronidazole; D014640:Vancomycin; D000077732:Fidaxomicin
keywords: C. difficile infection; C. difficile monoclonal antibodies; C. difficile prevention; C. difficile recurrence; C. difficile treatment; C. difficile vaccines; Clostridium difficile; fidaxomicin; metronidazole; rifaximin; vancomycin