Doctor, my patient has CDI and should continue to receive antibiotics. The (unresolved) risk of recurrent CDI.

Autores de IIS La Fe

• Iván Castro Hernández

  Autor

• María Tasias Pitarch

  Autor

• Eva Calabuig Muñoz

  Autor

• Miguel Salavert Lletí

  Autor

Grupos

• Infección Grave

• Investigacion clínica en enfermedades crónicas e Infección por el VIH

Abstract

Recurrence rate ranges from 12% to 40% of all cases of Clostridium difficile infection (CDI) and proposes an exceptional clinical challenge. Conventionally, treatment options of CDI have been limited to regimes of established antibiotics (eg, pulsed/tapered vancomycin) or "improvised" alternative antibiotics (eg. teicoplanin, tigecycline, nitazoxanide or rifaximin) occasionally even in combination, but faecal microbiota transplantation is emerging as a useful and quite safe alternative. In recent years, promising new strategies have emerged for effective prevention of recurrent CDI (rCDI) including new an-timicrobials (eg, fidaxomicin) and monoclonal antibodies (eg, bezlotoxumab). Despite promising progress in this area, difficulties remain for making the best use of these resources due to uncertainty over patient selection. This positioning review describes the current epidemiology of rCDI, its clinical impact and risk factors, some of the measures used for treating and preventing rCDI, and some of the emerging treatment options. It then describes some of the barriers that need to be overcome.

Keywords

• Clostridium difficile infection; recurrences; fidaxomicin; bezlotoxumab; faecal transplantation