title: Novel therapies for severe Clostridium difficile colitis.
abstract: OBJECTIVE
  Clostridium difficile infection (CDI) is becoming a large healthcare burden with increasing incidence, high recurrence rates, and associated morbidity and mortality. Disease severity varies from mild to severe and complicated presentations. Current mainstays of therapy in severe CDI include: fluid resuscitation, support of organ dysfunction, discontinuation of inciting agents, and antibiotic treatment.
  
  
  RESULTS
  Recent focus on the impact of the microbiome and targeted therapies to reconstitute biodiversity may provide alternative therapeutic modalities with higher success and lower recurrence rates. Newer antibiotics are under development, along with targeted immunotherapies that attempt to neutralize pathogenic toxins. Alternative surgical options from traditional subtotal colectomy may provide a less morbid surgical option for those requiring intervention.
  
  
  CONCLUSIONS
  With further understanding of the pathogenesis and shortcomings of current therapies, the future of management of CDI may include a multimodal approach focusing on microbiota and immunologic therapies that could result in improved cure with reduced recurrence.
authors.affiliation: aDepartment of Surgery, University of Pittsburgh bDepartment of Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
authors.forename: Paul
authors.initials: P
authors.lastname: Waltz
authors.forename: Brian
authors.initials: B
authors.lastname: Zuckerbraun
mesh_terms: D000890:Anti-Infective Agents / Q000627:therapeutic use*; D016360:Clostridioides difficile / Q000187:drug effects*; D003015:Clostridium Infections / Q000382:microbiology / Q000628:therapy*; D003092:Colitis / Q000382:microbiology / Q000628:therapy*; D000069467:Fecal Microbiota Transplantation / Q000379:methods* / Q000639:trends; D005440:Fluid Therapy / Q000379:methods* / Q000639:trends; D006801:Humans; D017410:Practice Guidelines as Topic; D012008:Recurrence; D012307:Risk Factors
chemical_list: D000890:Anti-Infective Agents