Clinical Laboratory of the Dr. R. A. Calderón Guardia Hospital, Costa Rica´s Social Security, San José, Costa Rica

*Corresponding Author: Gian Carlo González-Carballo, Clinical Laboratory of the Dr. R. A. Calderón Guardia Hospital, Costa Rica´s Social Security, San José, Costa Rica.

Received: December 08, 2023; Published: December 29, 2023

Abstract

Clostridioides difficile is one of the most important healthcare-associated pathogens in both developed and developing countries. Infections caused by this bacterium generate a high cost on health care systems. Traditionally, the management of this infection is given through therapy with antimicrobials such as metronidazole and vancomycin. However, with the increase in resistance to antibiotics and the emergence of hypervirulent and epidemic strains such as NAP1/027, the search for other therapeutic options is essential. The objective of this review is to study the first-line treatment that has been used for this bacterium, as well as to learn about new antibiotic molecules and active and passive immunization strategies that have emerged in recent years as alternative treatments, some of which are still are under investigation.

Keywords: Clostridioides difficile; Ridinilazole; Raja 42; Bezlotoxumab; Vaccines

References

1. Khan FY and Elzouki AN. “Clostridium difficile infection: a review of the literature”. Asian Pacific Journal of Tropical Medicine1 (2014): S6-S13.
2. Martin J., et al. “Clostridium difficile infection: epidemiology, diagnosis and understanding transmission”. Nature Reviews Gastroenterology and Hepatology4 (2016): 206-216.
3. Leffler DA and Lamont TJ. “Clostridium difficile infection”. The New England Journal of Medicine 16 (2015): 1539-1548.
4. Rineh A., et al. “Clostridium difficile infection: molecular pathogenesis and novel therapeutics”. Expert Review of Anti-Infective Therapy 1 (2014): 131-150.
5. Kouhsari E., et al. “Clostridium difficile infection: a review”. Reviews in Medical Microbiology 3 (2018): 103-109.
6. Kelly CR., et al. “ACG clinical guidelines: prevention, diagnosis and treatment of Clostridioides difficile infections”. American Journal of Gastroenterology. 6 (2021): 1124-1147.
7. Srinivasa FAZ., et al. “A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity”. Clinical Infectious Diseases 45.3 (2017): 302-307.
8. Shah , et al. “Impact of delayed oral vancomycin for severe Clostridium difficile infection”. Hospital Pharmacy 54.5 (2019): 294-299.
9. Baunwall SMD., et al. “Faecal microbiota transplantation for recurrent Clostridioides difficile infection: an updated systematic review and meta-analysis”. EClinicalMedicine 100642 (2020): 29-30.
10. Wortelboer K., et al. “Fecal microbiota transplantation beyond Clostridioides difficile infections”. EBioMedicine 44 (2019): 716-729.
11. Khanna S and Gerding DN. “Current and future trends in Clostridioides (Clostridium) difficile infection management”. Anaerobe 58 (2019): 95-102.
12. Basseres E., et al. “Impact on toxin production and cell morphology in Clostridium difficile infection by ridinilazole (SMT19969), a novel treatment for difficile infection”. Journal of Antimicrobial Chemotherapy 71.5 (2016): 1245-1251.
13. Thanissery R., et al. “Inhibition of spore germination, growth and toxin activity of clinically relevant C. difficile strains by gut microbiota derived secondary bile acids”. Anaerobe 45 (2017): 86-100.
14. Weiss W., et al. “In vivo assessment of SMT19969 in hamster model of Clostridium difficile infection”. Antimicrobial Agents and Chemotherapy 58 (2014): 5714-5718.
15. Cho JC., et al. “Ridinilazole: a novel antimicrobial for Clostridium difficile infection”. Annals of Gastroenterology 2 (2019): 134-140.
16. Freeman J., et al. “Susceptibility of Clostridium difficile isolates of varying antimicrobial resistance phenotypes to SMT19969 and 11 comparators”. Antimicrobial Agents and Chemotherapy 1 (2016): 689-692.
17. Goldstein E., et al. “Comparative in vitro activities of SMT19969, a new antimicrobial agent, against Clostridium difficile and 350 Gram-positive and Gram-negative aerobic and anaerobic intestinal flora isolates”. Antimicrobial Agents and Chemotherapy 10 (2013): 4872-4876.
18. Okhuysen PC., et al. “730. A phase 3, randomized, double-blind study to evaluate the efficacy and safety of ridinilazole compared with vancomycin for the treatment of Clostridioides difficile infection”. Open Forum Infectious Diseases 9.2 (2022).
19. Fong A., et al. “Raja 42, a novel gamma lactam compound, is effective against Clostridioides difficile”. PLoS ONE 9 (2021): e0257143.
20. Lee Y., et al. “Bezlotoxumab (Zinplava) for Clostridium difficile infection”. P&T 12 (2017): 735-738.
21. Gerding DN., et al. “Bezlotoxumab for prevention of recurrent Clostridum difficile infection in patients at increased risk for recurrence”. Clinical Infectious Diseases 5 (2018): 649-656.
22. Wilcox MH., et al. “Bezlotoxumab for prevention of recurrent Clostridium difficile infection”. The New England Journal of Medicine4 (2017): 305-317.
23. Bruxelle JF., et al. “Immunization strategies against Clostridium difficile”. Advances in Experimental Medicine and Biology 1050 (2018): 197-225.
24. Dieterle MG., et al. “Novel therapies and preventative strategies for primary and recurrent Clostridium difficile infections”. Annals of the New York Academy of Sciences 1 (2019): 110-138.

Citation

Citation: Gian Carlo González-Carballo. “Antibiotic and Immunological Alternatives for the Management of Clostridioides difficile Infection".Acta Scientific Microbiology 7.1 (2024): 77-81.

Copyright

Copyright: © 2024 Gian Carlo González-Carballo. 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.