Therapeutic approaches for Clostridium difficile infections

Curr Protoc Microbiol. 2013 Oct 2:30:9A.3.1-9A.3.9. doi: 10.1002/9780471729259.mc09a03s30.

Abstract

Metronidazole and vancomycin remain the front-line therapies for most Clostridium difficile infections (CDI). However, recurrent CDI occurs in ∼ 25% of patients, causing significant morbidity and mortality and healthcare costs. For this population, traditional antibiotic therapies fail and new treatment options are greatly needed. The US Food and Drug Administration recently approved fidaxomicin for CDI treatment. This narrow-spectrum antibiotic preserves the normal gut microbiota and shows promise as a treatment for severe and recurrent CDI. Monoclonal antibodies and vaccines directed against toxin are currently in clinical trials and represent alternative, non-antibiotic therapies. Less traditional therapeutic interventions include bacteriotherapy with non-toxigenic C. difficile and fecal transplant. This commentary will provide an overview of current and forthcoming CDI therapies.

Keywords: antibiotics; colitis; diarrhea; vaccine.

MeSH terms

  • Aminoglycosides / therapeutic use
  • Anti-Infective Agents / therapeutic use
  • Antibodies, Bacterial / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Antitoxins / therapeutic use
  • Bacterial Vaccines / therapeutic use
  • Biological Therapy / methods
  • Clostridioides difficile / isolation & purification*
  • Clostridium Infections / microbiology*
  • Clostridium Infections / therapy*
  • Diarrhea / drug therapy*
  • Diarrhea / microbiology*
  • Drug Therapy / methods
  • Fidaxomicin
  • Humans
  • Immunotherapy / methods
  • Metronidazole / therapeutic use
  • Vancomycin / therapeutic use

Substances

  • Aminoglycosides
  • Anti-Infective Agents
  • Antibodies, Bacterial
  • Antibodies, Monoclonal
  • Antitoxins
  • Bacterial Vaccines
  • Metronidazole
  • Vancomycin
  • Fidaxomicin