Leaping Forward in the Treatment of Clostridium difficile Infection: Update in 2015
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Outros Autores: | , , , , , |
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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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 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004 |
url |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
http://scielo.pt/scielo.php?script=sci_arttext&pid=S2341-45452015000600004 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
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 instacron:RCAAP |
instname_str |
Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
instacron_str |
RCAAP |
institution |
RCAAP |
reponame_str |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
collection |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
repository.name.fl_str_mv |
Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
repository.mail.fl_str_mv |
|
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1817550745740771328 |