An Updated Review of Clostridium difficile Treatment in Pediatrics

Campbell, Christopher T.; Poisson, M; Hand, Elizabeth

doi:10.5863/1551-6776-24.2.90

Cited by 10 publications

(8 citation statements)

References 59 publications

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“…In 2020, fidaxomicin received FDA (Food and Drug Administration) registration, which confirmed the safety and effectiveness of use in children over 6 months of age. Administration of this drug should be considered in the case of subsequent relapses [ 28 , 29 , 30 , 31 ]. We established the minimum inhibiting concentrations (MIC) of the two aforementioned antibiotics, which are routinely used in the treatment of antibiotic-associated diarrhoea, on the detected toxigenic strains of C. difficile.…”

Section: Discussionmentioning

confidence: 99%

The Hospital Environment as a Potential Source for Clostridioides difficile Transmission Based on Spore Detection Surveys Conducted at Paediatric Oncology and Gastroenterology Units

Lemiech-Mirowska

Michałkiewicz

Sierocka

et al. 2023

IJERPH

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Clostridioides difficile is an anaerobic, Gram-positive bacterium widely present in the hospital environment due to its ability to generate spores. The transfer of spores to patients through the hands of medical personnel is one of the most frequent paths of C. difficile transmission. In paediatric patients burdened with a serious primary illness requiring long-term hospitalisation and antibiotic therapy, C. difficile may be a significant risk factor for antibiotic-associated diarrhoea. The goal of the study was to assess the state of hospital environments as a potential source of C. difficile spores and to establish the share of hyperepidemic strains at the two paediatric units. The survey for C. difficile was conducted with a C. diff Banana BrothTM medium, used to detect spores and to recover vegetative forms of the bacteria. Environmental samples (n = 86) and swabs from the clothing of medical personnel (n = 14) were collected at two units of a paediatric hospital, where the cases of antibiotic-associated diarrhoea with a C. difficile aetiology constitute a significant clinical problem. In 17 samples, a change in the broth’s colour was observed, indicating the presence of spores. Out of seven samples, C. difficile strains were cultured. The pathogenic isolates of C. difficile were obtained from swabs collected from elements of beds, a toilet, a door handle and a doctor’s uniform. In our study, we indicated points of increased risk of pathogen transmission, which could constitute a source of infection. The clothing of medical personnel may be a dangerous carrier of pathogenic spores. Periodical surveys of hospital environments with the use of specialist microbiological mediums successfully indicate the direction of corrective actions to be undertaken by the medical facility in order to increase patient safety.

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Section: Discussionmentioning

confidence: 99%

The Hospital Environment as a Potential Source for Clostridioides difficile Transmission Based on Spore Detection Surveys Conducted at Paediatric Oncology and Gastroenterology Units

Lemiech-Mirowska

Michałkiewicz

Sierocka

et al. 2023

IJERPH

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“…8 Pediatric patients with mild CDAD are medically managed with oral metronidazole while the treatment for more severe infections is varied but generally includes oral vancomycin. 3,8 Fidaxomicin is a newer antibiotic option that can also be used for CDAD and is gaining traction particularly in the treatment of recurrent CDAD. 8 Fecal microbiota transplants have also been shown to be effective.…”

Section: Discussionmentioning

confidence: 99%

“…1 The risk of developing CDAD is significantly higher in pediatric patients with inflammatory bowel disease (IBD) 2 and may be associated with increased morbidity and mortality. 3 Currently, the medical management of pediatric patients with CDAD is based on evidence from adults. 3 There is no reliable way to predict which patients will fail medical management and require surgery.…”

Section: Introductionmentioning

confidence: 99%

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A Novel Surgical Treatment of Pediatric Fulminant Clostridium difficile Colitis

Hanson

Wagner

2021

Pediatrics

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Clostridium difficile associated disease (CDAD), inflammatory bowel disease (IBD), emergency department (ED), white count (WBC), C reactive protein (CRP), intravenous fluids (IVF), hospital day (HD), intensive care unit (ICU), polyethylene glycol (PEG), post-operative day (POD) Article Summary: We report the first pediatric case of the use of diverting loop ileostomy and colonic lavage to treat fulminant Clostridium difficile colitis.

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“…Standard treatment guidelines for CDI call for the use of antibiotics; persons experiencing greater than 3 loose stools within 24 hours and a positive stool immunoassay for C. difficile require treatment [ 13 – 16 ]. Current guidelines suggest a 10-day regimen of oral vancomycin, metronidazole, or fidaxomicin [ 3 , 14 , 17 , 18 ]. The need for antibiotics presents a health dilemma, as the new antibiotic may further disrupt intestinal flora and leaves the gut more susceptible to CDI recurrence weeks or even months following antibiotic cessation [ 2 , 7 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

Black Seed Oil, Bentonite Clay, and Probiotics: A Comprehensive Holistic Cure for Clostridium difficile Infection in a 2-Year-Old Female Child

Littman

Winningham

Carson

et al. 2022

Case Reports in Infectious Diseases

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There has been a rise in antibiotic resistance in secondary conditions such as Clostridium difficile (C. difficile) due to overuse of antibiotics. Oral antibiotics are used to treat C. difficile, which further disrupts the intestinal flora resulting in unwanted side effects. Naturopathic treatments often have fewer side effects and lower secondary infection risk than pharmaceutical interventions making them ideal for pediatric use. This case report describes the effective treatment of a pediatric clinical case of C. difficile using naturopathic and complementary alternative medicines (CAMs) including black seed oil (Nigella sativa), bentonite clay, and probiotics. A healthy two-year-old patient presented to a pediatrician with symptoms of, and subsequently confirmed, C. difficile after having been recently hospitalized and treated for a gluteal abscess and cellulitis using clindamycin, vancomycin, and piperacillin/tazobactam. Through a shared decision-making process, the patient’s mother and providers developed a treatment plan for the C. difficile infection (CDI), which included black seed oil, bentonite clay, and Lactobacillus probiotics. No C. difficile was detected via stool immunoassay after 4 days of combined CAM therapy. Our results underscore the need for additional research regarding the effectiveness of naturopathic CAMs including black seed oil, bentonite clay, and probiotics as alternatives to antibiotic treatment of CDI in children.

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An Updated Review of Clostridium difficile Treatment in Pediatrics

Cited by 10 publications

References 59 publications

The Hospital Environment as a Potential Source for Clostridioides difficile Transmission Based on Spore Detection Surveys Conducted at Paediatric Oncology and Gastroenterology Units

The Hospital Environment as a Potential Source for Clostridioides difficile Transmission Based on Spore Detection Surveys Conducted at Paediatric Oncology and Gastroenterology Units

A Novel Surgical Treatment of Pediatric Fulminant Clostridium difficile Colitis

Black Seed Oil, Bentonite Clay, and Probiotics: A Comprehensive Holistic Cure for Clostridium difficile Infection in a 2-Year-Old Female Child

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