The outcome of patients with severe and severe‐complicated <i>Clostridium difficile</i> infection treated with tigecycline combination therapy: a retrospective observational study

Bishop, Emma J.; Tiruvoipati, Ravindranath; Metcalfe, Julie; Marshall, Catherine; Botha, John; Kelley, Peter

doi:10.1111/imj.13742

Cited by 24 publications

(11 citation statements)

References 26 publications

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“…69 A small observational study found intravenous tigecycline (loading dose of 100 mg followed by 50 mg BID) as adjunct therapy to be marginally favorable to metronidazole-vancomycin therapy in terms of mortality. 70 Tigecycline monotherapy was superior in terms of progression to complicated disease and clinical cure when compared with combination therapy in a retrospective study with 90 patients. 71 A matched study did not find a difference in cure or recurrence when tigecycline was added to vancomycin therapy 72 ; another study found no mortality benefit when it was added to standard of care in a patient cohort primarily comprising of severe-complicated CDI.…”

Section: Treating Severe and Severe-complicated (Fulminant) Diseasementioning

confidence: 97%

Management of Clostridioides difficile colitis: insights for the gastroenterologist

Saha

Khanna

2019

Therap Adv Gastroenterol

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Clostridioides difficile infection (CDI) is a common cause of diarrhea in both inpatient and outpatient settings. The last few years have seen major changes in the treatment spectrum of CDI, most notably, recommendations against using metronidazole for initial CDI, the addition of fidaxomicin and bezlotoxumab, and emergence of microbial replacement therapies. Several other therapies are undergoing clinical trials. This narrative review focuses on the treatment of CDI with a summary of literature on the newer modalities and the treatment guidelines issued by Infectious Diseases Society of America and European Society of Clinical Microbiology and Infectious Diseases.

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Section: Treating Severe and Severe-complicated (Fulminant) Diseasementioning

confidence: 97%

Management of Clostridioides difficile colitis: insights for the gastroenterologist

Saha

Khanna

2019

Therap Adv Gastroenterol

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“…These data support the use of tigecycline in complicated and severe C difficile infection. Two retrospective studies confirm the safety of the drug in severely infected patients118 but failed to show an improvement compared with standard therapy in clinical cure or recurrence rate 119. If tigecycline is used to treat severe infections, it should be considered a substitute to metronidazole as adjunctive therapy to vancomycin.…”

Section: Treatmentmentioning

confidence: 99%

Clostridioides difficile: diagnosis and treatments

Guery

Galpérine

Barbut

2019

BMJ

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Clostridioides difficile (formerly Clostridium) is a major cause of healthcare associated diarrhea, and is increasingly present in the community. Historically, C difficile infection was considered easy to diagnose and treat. Over the past two decades, however, diagnostic techniques have changed in line with a greater understanding of the physiopathology of C difficile infection and the use of new therapeutic molecules. The evolution of diagnosis showed there was an important under- and misdiagnosis of C difficile infection, emphasizing the importance of algorithms recommended by European and North American infectious diseases societies to obtain a reliable diagnosis. Previously, metronidazole was considered the reference drug to treat C difficile infection, but more recently vancomycin and other newer drugs are shown to have higher cure rates. Recurrence of infection represents a key parameter in the evaluation of new drugs, and the challenge is to target the right population with the adapted therapeutic molecule. In multiple recurrences, fecal microbiota transplantation is recommended. New approaches, including antibodies, vaccines, and new molecules are already available or in the pipeline, but more data are needed to support the inclusion of these in practice guidelines. This review aims to provide a baseline for clinicians to understand and stratify their choice in the diagnosis and treatment of C difficile infection based on the most recent data available.

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“…84 Recently published retrospective studies have shown conflicting results regarding the efficacy of tigecycline for fulminant CDI. 85,86,87,88 Because of the poor outcomes associated with fulminant CDI, there may be a role for adjunctive tigecycline. 84 Consideration of surgical intervention and faecal microbiota transplantation (FMT) in such settings is also indicated.…”

Section: What Are the Recommended Treatment Options For An Initial Episode Of Fulminant Clostridioides Difficile Infection?mentioning

confidence: 99%

South African Society of Clinical Microbiology Clostridioides difficile infection diagnosis, management and infection prevention and control guideline

Nana

Moore²,

Boyles

et al. 2020

Southern African Journal of Infectious Diseases

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Clostridioides difficile infection (CDI) is a problem in both developed and developing countries and is a common hospital-acquired infection. This guideline provides evidence-based practical recommendations for South Africa and other developing countries. The scope of the guideline includes CDI diagnostic approaches; adult, paediatric and special populations treatment options; and surveillance and infection prevention and control recommendations.

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The outcome of patients with severe and severe‐complicated Clostridium difficile infection treated with tigecycline combination therapy: a retrospective observational study

Abstract: Tigecycline appears safe and effective as a part of combination therapy in severe CDI, and may be given earlier and for shorter durations than in current guidelines.

Cited by 24 publications

References 26 publications

Management of Clostridioides difficile colitis: insights for the gastroenterologist

Management of Clostridioides difficile colitis: insights for the gastroenterologist

Clostridioides difficile: diagnosis and treatments

South African Society of Clinical Microbiology Clostridioides difficile infection diagnosis, management and infection prevention and control guideline

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