Clostridium difficile infection: update on emerging antibiotic treatment options and antibiotic resistance

Expert Rev Anti Infect Ther. 2010 May;8(5):555-64. doi: 10.1586/eri.10.28.


Clostridium difficile infection (CDI) is the most common cause of identifiable diarrhea in hospitalized patients. The incidence and severity of CDIs are increasing. The increased incidence and severity of the disease has sparked interest in the optimal treatment of CDI as well as the use of new therapies and drug discovery. Current treatment strategies are inadequate with decreased response rates to metronidazole, and high recurrence rates with the use of metronidazole and oral vancomycin. Although incidence rates continue to be low, in vitro resistance to antibiotics used for the treatment of CDI has been noted. Recently, important data has emerged on new anti-C. difficile antibiotics such as rifaximin, rifalazil, fidaxomicin, nitazoxanide, tigecycline and ramoplanin. The purpose of this review is to provide an update on the in vitro susceptibility and new antibiotic treatment options for CDI. This review will focus primarily on scientific studies published in the last 36 months in order to provide an up-to-date review on the topic.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Aminoglycosides / administration & dosage
  • Aminoglycosides / pharmacology
  • Aminoglycosides / therapeutic use
  • Anti-Bacterial Agents* / administration & dosage
  • Anti-Bacterial Agents* / pharmacology
  • Anti-Bacterial Agents* / therapeutic use
  • Clinical Trials, Phase III as Topic
  • Clostridioides difficile / drug effects*
  • Clostridium Infections / drug therapy*
  • Clostridium Infections / microbiology
  • Drug Resistance, Bacterial*
  • Fidaxomicin
  • Humans
  • Microbial Sensitivity Tests
  • Nitro Compounds
  • Randomized Controlled Trials as Topic
  • Rifamycins / administration & dosage
  • Rifamycins / pharmacology
  • Rifamycins / therapeutic use
  • Rifaximin
  • Thiazoles / administration & dosage
  • Thiazoles / pharmacology
  • Thiazoles / therapeutic use
  • Treatment Outcome


  • Aminoglycosides
  • Anti-Bacterial Agents
  • Nitro Compounds
  • Rifamycins
  • Thiazoles
  • Rifaximin
  • nitazoxanide
  • Fidaxomicin