title: [Current treatment and epidemiology of Clostridium difficile infections].
abstract: During the past 10years, Clostridium difficile infections (CDI) have become a major public health challenge. Their epidemiology has changed with a rise in the number of cases and an increase in severe episodes. Recurrence and failure of conventional treatments have become more common. Furthermore, a spread of CDI has been observed in the general population-involving subjects without the usual risk factors (unexposed to antibiotic treatment, young people, pregnant women, etc.). All these change are partially due to the emergence of the hypervirulent and hyperepidemic clone NAP1/B1/027. New therapeutic strategies (antimicrobial treatment, immunoglobulins, toxin chelation, fecal microbiota transplantation) are now available and conventional treatments (metronidazole and vancomycin) have been reevaluated with new recommendations. Recent studies show a better efficacy of vancomycin compared to metronidazole for severe episodes. Fidaxomicin is a novel antibiotic drug with interesting features, including an efficacy not inferior to vancomycin and a lower risk of recurrence. Finally, for multi-recurrent forms, fecal microbiota transplantation seems to be the best option. We present the available data in this review.
authors.affiliation: Unité des maladies infectieuses, hôpitaux universitaires Paris Île-de-France Ouest, CHU Raymond-Poincaré, AP-HP, 104, boulevard R.-Poincaré, 92380 Garches, France. Electronic address: aurelien.dinh@rpc.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Dinh
authors.affiliation: Pharmacie, hôpitaux universitaires Paris Île-de-France Ouest, CHU Raymond-Poincaré, CHU Raymond-Poincaré, AP-HP, 104, boulevard R.-Poincaré, 92380 Garches, France.
authors.forename: F
authors.initials: F
authors.lastname: Bouchand
authors.affiliation: Laboratoire de microbiologie clinique, groupe hospitalier Paris Saint-Joseph, 185, rue Raymond-Losserand, 75014 Paris, France; EA 4043, faculté de pharmacie, université Paris-Sud, 5, rue Jean-Baptiste-Clément, 92296 Châtenay-Malabry cedex, France.
authors.forename: A
authors.initials: A
authors.lastname: Le Monnier
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D016360:Clostridioides difficile / Q000472:pathogenicity; D003015:Clostridium Infections / Q000453:epidemiology* / Q000628:therapy*; D003082:Colectomy / Q000379:methods; D000069467:Fecal Microbiota Transplantation; D005260:Female; D006801:Humans; D011247:Pregnancy; D019936:Probiotics / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiotique; Antimicrobial therapy; Clostridium difficile; Fecal microbiota transplantation; Fidaxomicine; Transplantation fécale; Vancomycine