A Comparison of Current Guidelines of Five International Societies on Clostridium difficile Infection Management

Abstract

Clostridium difficile infection (CDI) is increasingly recognized as an emerging healthcare problem of elevated importance. Prevention and treatment strategies are constantly evolving along with the apperance of new scientific evidence and novel treatment methods, which is well-reflected in the differences among consecutive international guidelines. In this article, we summarize and compare current guidelines of five international medical societies on CDI management, and discuss some of the controversial and currently unresolved aspects which should be addressed by future research.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-016-0122-1) contains supplementary material, which is available to authorized users.

Novel therapies and preventative strategies for primary and recurrent Clostridium difficile infections

“…The narrow‐spectrum activity of fidaxomicin potentially maintains the stability of the intestinal microbiota at a higher level, leading to a more transient loss of colonization resistance and more robust recovery of the microbiota after treatment. Fidaxomicin shows similar clinical cure rates with reduced recurrence rates . While fidaxomicin is more costly than vancomycin, the treatment may lower the overall cost by reducing recurrence rates if used to treat patients with a high recurrence risk …”

“…Fidaxomicin shows similar clinical cure rates with reduced recurrence rates . While fidaxomicin is more costly than vancomycin, the treatment may lower the overall cost by reducing recurrence rates if used to treat patients with a high recurrence risk …”

“…Fidaxomicin shows similar clinical cure rates with reduced recurrence rates. 9,[29][30][31] While fidaxomicin is more costly than vancomycin, the treatment may lower the overall cost by reducing recurrence rates if used to treat patients with a high recurrence risk. 29,32 Additionally, studies have been done on using alternative fidaxomicin dosing regimens for treating primary and recurrent CDI by looking at clinical cure rate and recurrence reduction.…”

Antisépticos y desinfectantes: apuntando al uso racional. Recomendaciones del Comité Consultivo de Infecciones Asociadas a la Atención de Salud, Sociedad Chilena de Infectología

“…Aun cuando está bien establecida la eficacia de soluciones alcohólicas para higiene de manos en comparación con el uso estándar de agua y jabón (Tabla 1), actualmente, respecto del manejo de la enfermedad diarreica por C. difficile existen múltiples recomendaciones de guías clínicas privilegiando el uso de agua y jabón por sobre las soluciones alcohólicas [20][21][22] . El sustento racional de tales recomendaciones nace en la pobre actividad lítica de los alcoholes contra las esporas de C. difficile, que llevaría a temer que el reemplazo del lavado de manos estándar por higiene en base a alcohol pudiese significar un aumento de las tasas de infección por C. difficile.…”

Control of Clostridium difficile Infection by Defined Microbial Communities

“…A brief description of treatment modalities is described later in the review to provide context for the use of microbial-based therapies for treatment of C. difficile infection. However, as neither author is a clinician, we point to several recent reviews (44-46) written by clinicians experienced in diagnosis and treatment of C. difficile that provide excellent detailed descriptions of the diagnosis and treatment of CDI in adults.…”