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World J Gastrointest Pharmacol Ther. 2014 Feb 6;5(1):1-26. doi: 10.4292/wjgpt.v5.i1.1.

Clinical update for the diagnosis and treatment of Clostridium difficile infection.

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1
Edward C Oldfield IV, Edward C Oldfield III, David A Johnson, Division of Gastroenterology, Division of Infectious Disease, Department of Internal Medicine, Eastern Virginia Medical School, Norfolk, VA 23508, United States.

Abstract

Clostridium difficile infection (CDI) presents a rapidly evolving challenge in the battle against hospital-acquired infections. Recent advances in CDI diagnosis and management include rapid changes in diagnostic approach with the introduction of newer tests, such as detection of glutamate dehydrogenase in stool and polymerase chain reaction to detect the gene for toxin production, which will soon revolutionize the diagnostic approach to CDI. New medications and multiple medical society guidelines have introduced changing concepts in the definitions of severity of CDI and the choice of therapeutic agents, while rapid expansion of data on the efficacy of fecal microbiota transplantation heralds a revolutionary change in the management of patients suffering multiple relapses of CDI. Through a comprehensive review of current medical literature, this article aims to offer an intensive review of the current state of CDI diagnosis, discuss the strengths and limitations of available laboratory tests, compare both current and future treatments options and offer recommendations for best practice strategies.

KEYWORDS:

Antibiotic-associated diarrhea; Clostridium difficile; Fecal transplantation; Fidaxomicin; Probiotics; Rifaximin

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