Antimicrobial therapy of Clostridium difficile-associated diarrhea

Med Clin North Am. 2006 Nov;90(6):1141-63. doi: 10.1016/j.mcna.2006.07.011.

Abstract

Clostridium difficile-associated diarrhea (CDAD) is the most common etiologically-defined cause of hospital-acquired diarrhea. Caused by the toxins of certain strains of C difficile, CDAD represents a growing concern, with epidemic outbreaks in some hospitals where very aggressive and difficult-to-treat strains have recently been found. Incidence of CDAD varies ordinarily between 1 to 10 in every 1,000 admissions. Evidence shows that CDAD increases morbidity, length of stay, and costs. This article described the clinical manifestations of CDAD, related risk factors, considerations for confirming CDAD, antimicrobial and non-antimicrobial treatment of CDAD, and issues related to relapses. The article concludes with a discussion of recent epidemic outbreaks involving CDAD.

Publication types

  • Review

MeSH terms

  • Aged
  • Anti-Infective Agents / adverse effects
  • Anti-Infective Agents / therapeutic use*
  • Bacterial Proteins / analysis
  • Bacterial Toxins / analysis
  • Clostridioides difficile / isolation & purification*
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / etiology
  • Clostridium Infections / immunology
  • Cross Infection / drug therapy
  • Cross Infection / etiology
  • Diarrhea / drug therapy*
  • Diarrhea / immunology
  • Disease Outbreaks
  • Feces / chemistry
  • Humans
  • Infant
  • Megacolon, Toxic / prevention & control
  • Metronidazole / therapeutic use
  • Nitro Compounds
  • Risk Factors
  • Secondary Prevention
  • Thiazoles / therapeutic use
  • Vancomycin / therapeutic use

Substances

  • Anti-Infective Agents
  • Bacterial Proteins
  • Bacterial Toxins
  • Nitro Compounds
  • Thiazoles
  • toxB protein, Clostridium difficile
  • Metronidazole
  • Vancomycin
  • nitazoxanide