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New Guidelines on Treatment of C. Difficile Released

February 23, 2018

The Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) have released an updated version of their 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The new update incorporates recommendations for children and endorses fecal microbiota transplantation (FMT) for the treatment of people with two or more recurrences of CDI after standard antibiotic treatment has not worked. It is now published online in the journal Clinical Infectious Diseases.

The new guidelines state that current research shows higher cure rates for CDI for vancomycin and fidaxomicin than for metronidazole. Therefore, metronidazole is no longer recommended as a first-line treatment for CDI.

Of note, the new guidelines make no recommendation on the use of Zinplava (bezlotoxumab; Merck and Co. Inc.), which was approved by the FDA in October 2016 as an adjunct to antibacterial treatment of CDI in adult patients who are at a high risk for CDI recurrence. In addition, there are no recommendations on the use of probiotics for the primary prevention of CDI.

Click here for a comprehensive summary of new guideline recommendations.

CDI remains a major public health problem in the U.S. It is associated with 15,000 to 30,000 deaths in the U.S. each year, and costs more than $4.8 billion in hospital care alone.

 

McDonald LC, Gerding DN, Johnson S, 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). Clin Infect Dis. 2018 Feb 15. doi: 10.1093/cid/cix1085. Available at: click here. [Epub ahead of print].