Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015

Detalhes bibliográficos
Autor(a) principal: Carmo,Joana
Data de Publicação: 2015
Outros Autores: Marques,Susana, Chapim,Iolanda, Túlio,Maria Ana, Rodrigues,José Pedro, Bispo,Miguel, Chagas,Cristina
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004
Resumo: In recent years, significant advances in the treatment of Clostridium difficile infection (CDI) have risen. We review the most relevant updated recommendations in the current standard of care of CDI and discuss emerging therapies, including antibiotic, alternative therapies (probiotics, toxin-binding resins, immunotherapy) and new data on fecal transplanttation. Upcoming surgical options and other rescue therapies for severe refractory disease are also addressed. Although oral metronidazole is a first-line therapy for non-severe CDI, emerging data have demonstrated its inferiority relatively to vancomycin, particularly in the setting of recurrent and/or severe infection. After a CDI recurrence for the first time, fidaxomicin has been shown to be associated with lower likelihood of CDI recurrence compared to vancomycin. Fecal transplantation is now strongly recommended for multiple recurrent CDI and may have a role in refractory disease. Oral, frozen stool capsules may simplify fecal transplantation in the future, with preliminary promising results. Diverting loop ileostomy combined with colonic lavage is a potential alternative to colectomy in severe complicated CDI. Potential alternative therapies requiring further investigation include toxin-binding resins and immunotherapy.
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spelling Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015Anti-Bacterial Agents/therapeutic useClostridium difficileClostridium Infections/therapyIn recent years, significant advances in the treatment of Clostridium difficile infection (CDI) have risen. We review the most relevant updated recommendations in the current standard of care of CDI and discuss emerging therapies, including antibiotic, alternative therapies (probiotics, toxin-binding resins, immunotherapy) and new data on fecal transplanttation. Upcoming surgical options and other rescue therapies for severe refractory disease are also addressed. Although oral metronidazole is a first-line therapy for non-severe CDI, emerging data have demonstrated its inferiority relatively to vancomycin, particularly in the setting of recurrent and/or severe infection. After a CDI recurrence for the first time, fidaxomicin has been shown to be associated with lower likelihood of CDI recurrence compared to vancomycin. Fecal transplantation is now strongly recommended for multiple recurrent CDI and may have a role in refractory disease. Oral, frozen stool capsules may simplify fecal transplantation in the future, with preliminary promising results. Diverting loop ileostomy combined with colonic lavage is a potential alternative to colectomy in severe complicated CDI. Potential alternative therapies requiring further investigation include toxin-binding resins and immunotherapy.Sociedade Portuguesa de Gastrenterologia2015-12-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articletext/htmlhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004GE-Portuguese Journal of Gastroenterology v.22 n.6 2015reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPenghttp://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004Carmo,JoanaMarques,SusanaChapim,IolandaTúlio,Maria AnaRodrigues,José PedroBispo,MiguelChagas,Cristinainfo:eu-repo/semantics/openAccess2024-02-06T17:33:38Zoai:scielo:S2341-45452015000600004Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-20T02:35:55.733683Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
title Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
spellingShingle Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
Carmo,Joana
Anti-Bacterial Agents/therapeutic use
Clostridium difficile
Clostridium Infections/therapy
title_short Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
title_full Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
title_fullStr Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
title_full_unstemmed Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
title_sort Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
author Carmo,Joana
author_facet Carmo,Joana
Marques,Susana
Chapim,Iolanda
Túlio,Maria Ana
Rodrigues,José Pedro
Bispo,Miguel
Chagas,Cristina
author_role author
author2 Marques,Susana
Chapim,Iolanda
Túlio,Maria Ana
Rodrigues,José Pedro
Bispo,Miguel
Chagas,Cristina
author2_role author
author
author
author
author
author
dc.contributor.author.fl_str_mv Carmo,Joana
Marques,Susana
Chapim,Iolanda
Túlio,Maria Ana
Rodrigues,José Pedro
Bispo,Miguel
Chagas,Cristina
dc.subject.por.fl_str_mv Anti-Bacterial Agents/therapeutic use
Clostridium difficile
Clostridium Infections/therapy
topic Anti-Bacterial Agents/therapeutic use
Clostridium difficile
Clostridium Infections/therapy
description In recent years, significant advances in the treatment of Clostridium difficile infection (CDI) have risen. We review the most relevant updated recommendations in the current standard of care of CDI and discuss emerging therapies, including antibiotic, alternative therapies (probiotics, toxin-binding resins, immunotherapy) and new data on fecal transplanttation. Upcoming surgical options and other rescue therapies for severe refractory disease are also addressed. Although oral metronidazole is a first-line therapy for non-severe CDI, emerging data have demonstrated its inferiority relatively to vancomycin, particularly in the setting of recurrent and/or severe infection. After a CDI recurrence for the first time, fidaxomicin has been shown to be associated with lower likelihood of CDI recurrence compared to vancomycin. Fecal transplantation is now strongly recommended for multiple recurrent CDI and may have a role in refractory disease. Oral, frozen stool capsules may simplify fecal transplantation in the future, with preliminary promising results. Diverting loop ileostomy combined with colonic lavage is a potential alternative to colectomy in severe complicated CDI. Potential alternative therapies requiring further investigation include toxin-binding resins and immunotherapy.
publishDate 2015
dc.date.none.fl_str_mv 2015-12-01
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dc.identifier.uri.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004
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dc.publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
publisher.none.fl_str_mv Sociedade Portuguesa de Gastrenterologia
dc.source.none.fl_str_mv GE-Portuguese Journal of Gastroenterology v.22 n.6 2015
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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