Acta Scientific Gastrointestinal Disorders (ASGIS)(ISSN: 2582-1091)

Review Article Volume 5 Issue 8

“What’s the Deal with Clostridium Difficile?”

Samuel M John*, Adrian Gavre, Yasmin Abu-Abed and Karan Shah

Associate Professor of Pharmacy Practice, Philadelphia College of Osteopathic Medicine School of Pharmacy, USA

*Corresponding Author: Samuel M John, Associate Professor of Pharmacy Practice, Philadelphia College of Osteopathic Medicine School of Pharmacy, USA.

Received: June 28, 2022; Published: July 29, 2022

Abstract

Introduction: Clostridioides (Clostridium) Difficile is a serious infection associated with deaths and hospitalizations. According to the Centers for Disease and Control (CDC) Prevention, Clostridioides (Clostridium) Difficile infections (CDI) can be labeled as a threat to healthcare. The introduction of novel agents onto the market have prompted changes in the way we treat CDI, providing clinicians with more robust options, as evidenced by updates to clinical practice guidelines.

Discussion: Exposure to antibiotics (i.e., clindamycin, penicillins, cephalosporins, etc.) are associated with the highest risk in the development of CDI. Presentation can range on a spectrum from asymptomatic carrier to episodic diarrhea to more serious cases such as shock which can lead to death. A proper understanding of risk factors, eliminating unnecessary medications, identifying correct methods in the diagnosis of CDI can help clinicians properly treat patients with the goal to eradicate the infection and prevent recurrence which can lead to a decreased quality of life for the patient.

Conclusions: The approach to the management of CDI in both healthcare institutions and the community involves a coordinated effort between patients, pharmacists and physicians. The recent updates to the guidelines from the Infectious Disease Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) highlight the value of two novel agents fidaxomicin and bezlotoxumab in treating CDI and its importance in prevention of hospitalizations and recurrence. The economic factors associated with these newer agents and its cost-effectiveness continues to be evaluated through clinical studies.

 

Keywords: C. difficile; IDSA; CDI; bezlotoxumab; SHEA

References

  1. Czepiel J., et al. “Clostridium difficile infection: review”. European Journal of Clinical Microbiology and Infectious Diseases 7 (2019): 1211-1221.
  2. Depestel DD and Aronoff DM. “Epidemiology of Clostridium difficile infection”. Journal of Pharmacy Practice 5 (2013): 464-475.
  3. Centers for Disease Control and Prevention (CDC) (2019b).
  4. Brown KA., et al. “Meta-analysis of antibiotics and the risk of community-associated Clostridium difficile infection”. Antimicrobial Agents and Chemotherapy 57 (2013): 2325-2332.
  5. Pepin J., et al. “Emergence of fluoroquinolones as the predominant risk factor for Clostridium difficile-associated diarrhea: a cohort study during an epidemic in Quebec”. Clinical Infectious Diseases 41 (2005): 1254-1260.
  6. Kuntz JL., et al. “Predicting the risk of Clostridium difficile infection following an outpatient visit: development and external validation of a pragmatic, prognostic risk score”. Clinical Microbiology and Infection 21 (2015): 256-262.
  7. McDonald CL., et al. “Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)”. Clinical Infectious Diseases 66 (2018): e1-e48.
  8. Surawicz CM., et al. “Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections”. American Journal of Gastroenterology 108 (2013): 478-498.
  9. Bloomfield MG., et al. “Risk factors for mortality in Clostridium difficile infection in the general hospital population: a systematic review”. Journal of Hospital Infection 82 (2012): 1-12.
  10. Cornely OA., et al. “Clinical efficacy of fidaxomicin compared with vancomycin and metronidazole in Clostridium difficile infections: a meta-analysis and indirect treatment comparison”. Journal of Antimicrobial Chemotherapy 69 (2014): 2892-900.
  11. Gallagher JC., et al. “Clinical and economic benefits of fidaxomicin compared to vancomycin for Clostridium difficile infection”. Antimicrobial Agents and Chemotherapy 11 (2015): 7007-7010.
  12. Thompson CA. “CMS to compensate hospitals for inpatient use of fidaxomicin, glucarpidase”. American Journal of Health-System Pharmacy 69 (2012): 1618-1619.
  13. Zar FA., et al. “A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity”. Clinical Infectious Diseases 45 (2007): 302-307.
  14. McFarland LV., et al. “Breaking the cycle: treatment strategies for 163 cases of recurrent Clostridium difficile disease”. American Journal of Gastroenterology 7 (2002): 1769-1775.
  15. Johnson S., et al. “Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults”. Clinical Infectious Diseases 5 (2012): e1029-e1044.
  16. Cammarota G., et al. “European consensus conference on faecal microbiota transplantation in clinical practice”. Gut4 (2017): 569-580.
  17. Wilcox MH., et al. “Bezlotoxumab for prevention of recurrent Clostridium difficile infection”. The New England Journal of Medicine 376 (2017): 305-317.
  18. Van Prehn J., et al. “European Society of Clinical Microbiology and Infectious Diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults”. Clinical Microbiology and Infection 2 (2021): S1-S21.

Citation

Citation: Samuel M John., et al.. ““What’s the Deal with Clostridium Difficile?”". Acta Scientific Gastrointestinal Disorders 5.8 (2022): 83-88.

Copyright

Copyright: © 2022 Samuel M John., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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