New advances in the treatment of <em>Clostridium difficile</em> infection (CDI)

Abstract

Clostridium diffi cile infections (CDI) have increased in frequency throughout the world. In addition to an increase in frequency, recent CDI epidemics have been linked to a hypervirulent C. diffi cile strain resulting in greater severity of disease. Although most mild to moderate cases of CDI continue to respond to metronidazole or vancomycin, refractory and recurrent cases of CDI may require alternative therapies. This review provides a brief overview of CDI and summarizes studies involving alternative antibiotics, toxin binders, probiotics, and immunological therapies that can be considered for treatment of acute and recurrent CDI in severe and refractory situations.

Progress in the Discovery of Treatments for C. difficile Infection: A Clinical and Medicinal Chemistry Review

“…The use of human monoclonal antibodies against C. difficile toxin is in the early clinical stages [ 39 ]. A phase 2 randomized, double-blind, placebo-controlled study evaluated the effect of a single infusion of human monoclononal antibodies against C. difficile toxins A and B in symptomatic CDI patients receiving treatment with MTZ or VAN.…”

“…This indicated that C. difficile may be undetected by EIA and PCR may be a better diagnostic tool [ 38 ]. Additional methods of detecting C. difficile include culturing the unformed stool [ 36 ], nucleic acid amplification test [ 36 ], and detection of glutamate dehydrogenase enzyme (screening) produced by both toxic and nontoxic C. difficile [ 36 , 39 ]. C. difficile stool culture is slow to yield results and is of limited diagnostic value since only toxigenic C. difficile causes the diarrhea associated with CDI [ 14 ].…”