New concepts in C. difficile management

Abstract

Background: Clostridium difficile infection is transmitted via spores, and the disease is mediated via secreted toxins. It represents a significant healthcare problem, and clinical presentation can range from asymptomatic carriage to life-threatening pseudomembranous colitis.

Sources of data: publications in the field, with a focus on recent developments and concepts.

Areas of agreement: infection control measures, antibiotic stewardship and current management of the initial episode of C. difficile infection.

Areas of controversy: selection and sequence of interventions for the management of recurrent C. difficile infection; management of persistent carriers of toxigenic C. difficile in patients at high risk of subsequent C. difficile infection.

Growing points: use of faecal microbiota transplantation for recurrent C. difficile infection.

Areas timely for developing research: role of specific microbiota-mediated interventions and vaccination in the treatment and prevention of C. difficile infection.

Keywords: antibiotics; colitis; diarrhoea; microbiota.