Intravenous immunoglobulin therapy for severe <i>Clostridium difficile</i> colitis

Salcedo, José R.; Keates, Sarah; Pothoulakis, C; Warny, Michel; Castagliuolo, Ignazio; LaMont, J. Thomas; Kelly, Ciarán P.

doi:10.1136/gut.41.3.366

Cited by 234 publications

(130 citation statements)

References 39 publications

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“…Kyne et al (2001) studied 63 patients with CDAD and found serum IgG antitoxin A levels were significantly lower for patients who developed further recurrences compared to patients who only had one episode. A total of 17 patients with recurrent CDAD, from five case series reports, have been treated with intravenous human immunoglobulin and 15 responded to this treatment (Leung et al, 1991;Hassett et al, 1995;Salcedo et al, 1997;Beales, 2002;Wilcox, 2004). Most patients given intravenous immunoglobulin treatments were adults, although one report was a series of six children aged 6-37 months (Leung Leung et al, 1991).…”

Section: Immune Productsmentioning

confidence: 99%

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Alternative treatments for Clostridium difficile disease: what really works?

McFarland

2005

Journal of Medical Microbiology

141

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Vancomycin and metronidazole have been used for treating Clostridium difficile-associated disease (CDAD) for the past 25 years, but approximately 20 % of patients develop recurrent disease. The increasing incidence of nosocomial outbreaks, cases of recurrent CDAD and other complications (toxic megacolon, ileus, sepsis) has fuelled the search for different types of treatments. As the understanding of the pathogenesis of this disease has matured, newer treatment strategies that take advantage of these mechanisms have been developed. This review will describe such treatments and examine the evidence for each strategy.

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Section: Immune Productsmentioning

confidence: 99%

“…Studies to date lack appropriate control groups, and doses, durations and timings of IgG treatment have not been standardized. In addition, different preparations of commercial pooled immunoglobulin have varying amounts of anti-CDT antibodies present (Salcedo et al, 1997).…”

Section: Immune Productsmentioning

confidence: 99%

Alternative treatments for Clostridium difficile disease: what really works?

McFarland

2005

Journal of Medical Microbiology

141

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“…18-21 However, IgG titers against C. difficile toxins in commercial immunoglobulin preparations have been shown to vary by as much as fourfold. 18 In addition, the pharmacokinetics of these preparations for treating C. difficile-associated infection has not been characterized.…”

Section: Discussionmentioning

confidence: 99%

“…16,[20][21] Patients with severe, refractory and fulminant CDAD are another patient population that may benefit substantially from passive immunotherapy. 18 The clinical outcomes in this situation are often grim including multi-organ failure, colectomy and death. There is no available treatment with proven efficacy beyond antibacterial therapy with vancomycin and metronidazole.…”

Section: Discussionmentioning

confidence: 99%

Open-label, dose escalation phase I study in healthy volunteers to evaluate the safety and pharmacokinetics of a human monoclonal antibody to Clostridium difficile toxin A

Taylor

Tummala

Molrine

et al. 2008

Vaccine

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“…This interest is based upon the fact that development of C. difficile antitoxin antibody has been associated with protection from the development of CDI after colonization with C. difficile [50,163] . Small se-ries and case reports have suggested a possible response to IVIG [164,165] . Of note, all immunoglobulin lots tested contained IgG against toxins A and B and were capable of neutralizing cytotoxicity in one series [166] .…”

Section: Binding Resinsmentioning

confidence: 99%

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

Oldfield

Johnson

2014

WJGPT

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Clostridium difficile infection (CDI) presents a rapidly evolving challenge in the battle against hospitalacquired infections. Recent advances in CDI diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to CDI. New medications and multiple medical society guidelines have introduced changing concepts in the definitions of severity of CDI and the choice of therapeutic agents, while rapid expansion of data on the efficacy of fecal microbiota transplantation heralds a revolutionary change in the management of patients suffering multiple relapses of CDI. Through a comprehensive review of current medical literature, this article aims to offer an intensive review of the current state of CDI diagnosis, discuss the strengths and limitations of available laboratory tests, compare both current and future treatments options and offer recommendations for best practice strategies.

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Intravenous immunoglobulin therapy for severe Clostridium difficile colitis

Cited by 234 publications

References 39 publications

Alternative treatments for Clostridium difficile disease: what really works?

Alternative treatments for Clostridium difficile disease: what really works?

Open-label, dose escalation phase I study in healthy volunteers to evaluate the safety and pharmacokinetics of a human monoclonal antibody to Clostridium difficile toxin A

Clinical update for the diagnosis and treatment ofClostridium difficileinfection

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