Table 21Summary of case studies/series and potential harms of nonstandard interventions for CDI

Intervention# of ReportsPatient NType of CDI PatientStudy AimOutcomeReported Adverse Events
Fecal flora reconstitution696,97,128-130,19360Recurrent CDITreatment73% – 100% symptom free, up to 1 year1 case IBS
Cholestyramine2191,1922CDI with PMCTreatment, primary CDI1 patient rapid symptom reliefNot reported
IV hemoperfusion, vancomycin12012CDI with PMCTreatment, primary CDIPMC resolved in 7 daysNot reported
Probiotics393,189,1905 (plus 57 from literature review)4 ICU patients,1 recurrent CDI (plus 41 patients with fungemia, 14 ICU)Treatment1 case S. pneumonaie and secondary L. rhamnosus septicemia and death. 46% fungemia patients previously given probiotics
Nontoxigenic C. difficile strain12002CDI patients failing antibiotic treatmentTreatmentSymptom decrease, 1 patient resolvedConstipation
Monoclonal antibody for C. difficile toxin A119430Healthy young adultsSafety study3 moderate AE (low BP, diarrhea), 18 mild AE (headache, nausea, loose stools, abdominal discomfort BP changes)
Intravenous Tigecycline11984CDI with PMCTreatment, severe refractorySymptom decrease within 7 daysNot reported
C. difficile toxoid vaccines2199,2023 (plus 30 healthy adults)First CDI relapseTreatment (safety study)Mild headache, mild abdominal pain, rash, 1 CDI relapse patient polyarthritis
Intravenous immunoglobulin483,106,196,19737CDI, recurrent, refractory, severely illTreatment54% symptom resolution, of these, 20% patients had recurrence or toxin still present1 case pulmonary edema

AE = adverse event; BP = blood pressure; CDI = Clostridium difficile infection; IBS = irritable bowel syndrome; ICU = intensive care unit; IV = intravenous; PMC = pseudomembranous colitis

From: Results

Cover of Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection
Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection [Internet].
Comparative Effectiveness Reviews, No. 31.
Butler M, Bliss D, Drekonja D, et al.

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