Treatment of Clostridium difficile infection in pediatric patients.
Clostridium difficile causes infections that can either remain asymptomatic or manifest as clinical disease. In this report, problems, possible solutions, and future perspectives on the treatment of C. difficile infections (CDIs) in pediatric patients are discussed. CDI, despite increasing as a consequence of the overuse and misuse of antibiotics, remains relatively uncommon in pediatrics mainly because younger children are poorly susceptible to the action of C. difficile toxins. In most such cases, C. difficile disease is mild to moderate and discontinuation of the administered antibiotics in patients receiving these drugs when CDI develops, or administration of metronidazole, is sufficient to solve this problem. In severe or frequently relapsing cases, vancomycin is the drug of choice. Probiotics do not seem to add significant advantages. Other treatment options must be reserved for severe cases and be considered as a salvage treatment, although potential advantages in pediatric patients remain unclear.
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Susanna
S
Esposito
Giulia
G
Umbrello
Luca
L
Castellazzi
Nicola
N
Principi
D000293:Adolescent; D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D016360:Clostridioides difficile / Q000472:pathogenicity*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000382:microbiology / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation / Q000009:adverse effects; D005243:Feces / Q000382:microbiology; D006801:Humans; D007223:Infant; D007422:Intestines / Q000382:microbiology*; D019936:Probiotics / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents
Clostridium difficile; antibiotic therapy; children; fecal microbiological transplantation; gastrointestinal infection; probiotics