Australasian Society of Infectious Diseases updated guidelines for the management of <i>Clostridium difficile</i> infection in adults and children in Australia and New Zealand

Trubiano, Jason A; Cheng, Allen; Korman, Tony M.; Röder, Christine; Campbell, Anita J.; May, Meryta; Blyth, Christopher C; Ferguson, John; Blackmore, Timothy; Riley, Thomas V.; Athan, Eugene

doi:10.1111/imj.13027

Cited by 100 publications

(139 citation statements)

References 159 publications

(324 reference statements)

Supporting

Mentioning

136

Contrasting

Unclassified

Order By: Relevance

“…Comment : In patients with rCDI preinfusion use of metronidazole, vancomycin or fidaxomicin should be performed for at least 3 days,1–3 17 20–22 in order to repress the abundance of intestinal C. difficile . However, antibiotics should be stopped 12–48 hours before stool application.…”

Section: Resultsmentioning

confidence: 99%

“…17 20 21 As bowel lavage is able to reduce the abundance of C. difficile , it is also reasonable to suggest it also when FMT is performed via upper GI tract 12 52 53 However, there is some report showing high success rate of FMT performed via upper GI tract and without prior bowel lavage 54.…”

Section: Resultsmentioning

confidence: 99%

“…[14][15][16] The global interest in FMT is increasing, and both doctors and patients are increasingly aware and informed. Although the dissemination of FMT in the clinical practice is restricted by regulatory and bureaucratic issues ( principally related to costs, donor programme, safety control), [17][18][19] the FMT practice is booming, ranging from highly organised stool banking programmes to individual treatments with patient-identified directed donors, and even to individual and harmful do-it-yourself practices. Working groups (WGs) from the USA, Austria and France released recommendations on indications and methods of FMT.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

European consensus conference on faecal microbiota transplantation in clinical practice

Cammarota

Ianiro

Tilg

et al. 2017

Gut

906

848

View full text Add to dashboard Cite

Faecal microbiota transplantation (FMT) is an important therapeutic option for Clostridium difficile infection. Promising findings suggest that FMT may play a role also in the management of other disorders associated with the alteration of gut microbiota. Although the health community is assessing FMT with renewed interest and patients are becoming more aware, there are technical and logistical issues in establishing such a non-standardised treatment into the clinical practice with safety and proper governance. In view of this, an evidence-based recommendation is needed to drive the practical implementation of FMT. In this European Consensus Conference, 28 experts from 10 countries collaborated, in separate working groups and through an evidence-based process, to provide statements on the following key issues: FMT indications; donor selection; preparation of faecal material; clinical management and faecal delivery and basic requirements for implementing an FMT centre. Statements developed by each working group were evaluated and voted by all members, first through an electronic Delphi process, and then in a plenary consensus conference. The recommendations were released according to best available evidence, in order to act as guidance for physicians who plan to implement FMT, aiming at supporting the broad availability of the procedure, discussing other issues relevant to FMT and promoting future clinical research in the area of gut microbiota manipulation. This consensus report strongly recommends the implementation of FMT centres for the treatment of C. difficile infection as well as traces the guidelines of technicality, regulatory, administrative and laboratory requirements.

show abstract

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

European consensus conference on faecal microbiota transplantation in clinical practice

Cammarota

Ianiro

Tilg

et al. 2017

Gut

906

848

View full text Add to dashboard Cite

show abstract

“…Its somewhat higher resistance rates as compared to vancomycin and metronidazole—especially in binary toxin negative strains—and the possibility of resistance emergence during CDI therapy are additional issues of concern [15–19]. Today it may only be recommended as a “chaser” therapy after vancomycin treatment to reduce CDI recurrence risk [20], based on the results of case series [19, 21] and a small RCT [22]. A larger phase IV RCT to verify these data is currently recruiting participants [23].…”

Section: Antibiotics and Non-antibiotic Anticlostridial Agentsmentioning

confidence: 99%

“…That the restoration of an impaired intestinal microbiota by transplanting feces of a healthy individual may effectively cure CDI and prevent recurrences is not questioned any more [1, 20]. Its efficacy was proven in two already published phase II RCTs [206, 207], and another phase II RCT performed on pediatric patients has also recently been completed [208], whose results are not yet available.…”

Section: Restoration and Modulation Of The Intestinal Microbiotamentioning

confidence: 99%

A Review of Experimental and Off-Label Therapies for Clostridium difficile Infection

2016

View full text Add to dashboard Cite

In spite of increased awareness and the efforts taken to optimize Clostridium difficile infection (CDI) management, with the limited number of currently available antibiotics for C. difficile the halt of this increasing epidemic remains out of reach. There are, however, close to 80 alternative treatment methods with controversial anti-clostridial efficacy or in experimental phase today. Indeed, some of these therapies are expected to become acknowledged members of the recommended anti-CDI arsenal within the next few years. None of these alternative treatment methods can respond in itself to all the major challenges of CDI management, which are primary prophylaxis in the susceptible population, clinical cure of severe cases, prevention of recurrences, and forestallment of asymptomatic C. difficile carriage and in-hospital spread. Yet, the greater the variety of treatment choices on hand, the better combination strategies can be developed to reach these goals in the future. The aim of this article is to provide a comprehensive summary of these experimental and currently off-label therapeutic options.

show abstract

Physician and patient perceptions of fecal microbiota transplant for recurrent or refractory Clostridioides difficile in the first 6 years of a central stool bank

et al. 2020

View full text Add to dashboard Cite

Background and Aim: Fecal microbiota transplantation (FMT) is a highly effective therapy for recurrent or refractory Clostridioides difficile infection (rCDI). Despite inclusion in society guidelines, the uptake of FMT therapy has been variable. Physician and patient attitudes may be a barrier to evidence-based uptake of therapies; however, data assessing attitudes regarding FMT for rCDI are limited. Methods: The South Australian FMT for CDI database prospectively recorded patient outcomes of FMT for CDI from August 2013 to January 2019. A total of 93 consecutive patients who underwent FMT for rCDI in South Australia were invited to participate in a 20-question survey regarding the patient experience of FMT. All gastroenterologists and infectious disease physicians practicing in South Australia were invited to participate in an online survey comprised of 22 questions that addressed referral experience, indications for referral, perceived risks, and regulation and funding. Results: Fifty-four patients (54/93, 58%) returned the survey, of whom 52 (96%) would recommend FMT to others, and 51 (94%) were satisfied with treatment outcome. Fifty physicians returned the online survey (50/100, 50%), of whom 23 (46%) were concerned about disease transmission risk, and 15 (30%) believed that the risk of FMT would outweigh the benefit. Infectious diseases physicians and advanced trainees had significantly greater concern regarding the potential alteration of the microbiome than gastroenterology physicians and advanced trainees (8/17 (47%) vs 6/ 33 (18%); P = 0.047). Conclusion: Despite high levels of patient-reported satisfaction following FMT, physician-reported reservations exist and may present a barrier to uptake of this therapy.

show abstract

Australasian Society of Infectious Diseases updated guidelines for the management of Clostridium difficile infection in adults and children in Australia and New Zealand

Cited by 100 publications

References 159 publications

European consensus conference on faecal microbiota transplantation in clinical practice

European consensus conference on faecal microbiota transplantation in clinical practice

A Review of Experimental and Off-Label Therapies for Clostridium difficile Infection

Physician and patient perceptions of fecal microbiota transplant for recurrent or refractory Clostridioides difficile in the first 6 years of a central stool bank

Contact Info

Product

Resources

About