Clostridium difficile infection: new approaches to prevention, non-antimicrobial treatment, and stewardship

Expert Rev Anti Infect Ther. 2017 Nov;15(11):1027-1040. doi: 10.1080/14787210.2017.1387535. Epub 2017 Oct 9.

Abstract

Despite the large amount of scientific publications exploring the epidemiology and the clinical management of Clostridium difficile (CD) infection, some issues remain unsolved or need further studies. The aim of this review is to give an update on the hot topics on CD prevention, including stewardship programs, and on the non-microbiological treatment of CD infection. Areas covered: This article will review the importance of minimizing the CD spore shedding in the healthcare environment for potentially reducing CD transmission. Moreover, antimicrobial stewardship programs aimed to reduce CD incidence will be reviewed. Finally, new strategies for reducing CD infection recurrence will be described. Expert commentary: Besides the basic infection control and prevention practices, including hand hygiene, contact isolation and environmental cleaning, in the prevention of CD infection other issues should be addressed including minimizing the spread of CD in the healthcare setting, and implementing the best strategy for reducing CD infection occurrence, including tailored antimicrobial stewardship programs. Regarding new advancements in treatment and management of CDI episodes, non-antimicrobial approaches seem to be promising in reducing and managing recurrent CD infection.

Keywords: Clostridium difficile; albumin; antimicrobial stewardship; immunity; infection prevention and control; microbiota; non-antimicrobial treatment.

Publication types

  • Review

MeSH terms

  • Aminoglycosides / metabolism
  • Aminoglycosides / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use*
  • Antimicrobial Stewardship / organization & administration*
  • Clostridioides difficile / drug effects
  • Clostridioides difficile / growth & development
  • Clostridioides difficile / pathogenicity
  • Clostridium Infections / microbiology
  • Clostridium Infections / pathology
  • Clostridium Infections / therapy*
  • Cross Infection / prevention & control
  • Fecal Microbiota Transplantation*
  • Fidaxomicin
  • Hand Hygiene / organization & administration
  • Humans
  • Incidence
  • Infection Control / methods*
  • Probiotics / therapeutic use
  • Spores, Bacterial / drug effects
  • Spores, Bacterial / growth & development
  • Spores, Bacterial / pathogenicity

Substances

  • Aminoglycosides
  • Anti-Bacterial Agents
  • OP-1118
  • Fidaxomicin