Fitzpatrick, F, Skally, M, Brady, M et al. (3 more authors) (2018) European Practice for CDI Treatment. In: Mastrantonio, P and Rupnik, M, (eds.) Updates on Clostridium difficile in Europe. Advances in Experimental Medicine and Biology, 1050 . Springer Nature , pp. 117-135. ISBN 978-3-319-72799-8
Abstract
Clostridium difficile infection (CDI) remains a significant cause of morbidity and mortality worldwide. Historically, two antibiotics (metronidazole and vancomycin) and a recent third (fidaxomicin) have been used routinely for CDI treatment; convincing data are now available showing that metronidazole is the least efficacious agent. The European Society of Clinical Microbiology and Infectious Diseases CDI treatment guidelines outline the treatment options for a variety of CDI clinical scenarios, including use of the more traditional anti-CDI therapies (e.g., metronidazole, vancomycin), the role of newer anti-CDI agents (e.g., fidaxomicin), indications for surgical intervention and for non-antimicrobial management (e.g., faecal microbiota transplantation, FMT). A 2017 survey of 20 European countries found that while the majority (n = 14) have national CDI guidelines that provide a variety of recommendations for CDI treatment, only five have audited guideline implementation. A variety of restrictions are in place in 13 (65%) countries prior to use of new anti-CDI treatments, including committee/infection specialist approval or economic review/restrictions. Novel anti-CDI agents are being evaluated in Phase III trials; it is not yet clear what will be the roles of these agents. Prophylaxis is an optimum approach to reduce the impact of CDI especially in high-risk populations; monoclonal antibodies, antibiotic blocking approaches and multiple vaccines are currently in advanced clinical trials. The treatment of recurrent CDI is particularly troublesome, and several different live bio therapeutics are being developed, in addition to FMT.
Metadata
Item Type: | Book Section |
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Authors/Creators: |
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Editors: |
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Copyright, Publisher and Additional Information: | © Springer International Publishing AG 2018. This is an author produced version of a chapter in Mastrantonio P., Rupnik M. (eds) Updates on Clostridium difficile in Europe. Advances in Experimental Medicine and Biology, vol 1050. Springer, Cham. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | C. difficile treatment; Anti-CDI agents; CDI guidelines; Novel C. difficile agents; C. difficile prophylaxis |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > Institute of Molecular Medicine (LIMM) (Leeds) > Section of Molecular Gastroenterology (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 23 Aug 2018 11:18 |
Last Modified: | 31 Jan 2020 01:38 |
Status: | Published |
Publisher: | Springer Nature |
Series Name: | Advances in Experimental Medicine and Biology |
Identification Number: | 10.1007/978-3-319-72799-8_8 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:134867 |