Guidance updated for managing C. difficile infection in adults

(HealthDay)—Use of fidaxomicin and bezlotoxumab is suggested in specific cases for management of Clostridioides difficile infection (CDI), according to a clinical practice guideline update issued by the Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America and published online June 24 in Clinical Infectious Diseases.

Stuart Johnson, M.D., from the Loyola University Medical Center in Maywood, Illinois, and colleagues present updated recommendations for the management of CDI in adults, specifically addressing use of fidaxomicin and bezlotoxumab for CDI treatment.

The authors suggest using fidaxomicin for an initial CDI episode, rather than a standard course of vancomycin, while vancomycin remains an acceptable alternative. Fidaxomicin (standard or extended-pulsed regimen) is suggested rather than a standard course of vancomycin in patients with recurrent CDI episodes; vancomycin remains an acceptable alternative for first recurrence. Bezlotoxumab is suggested as a co-intervention with standard-of-care antibiotics rather than standard-of-care antibiotics alone for patients with a recurrent CDI episode within the last six months.

"Head-to-head trials of differing anti-CDI recurrence strategies using narrow-spectrum antibiotics that target C. difficile, restoration of the microbiome using biotherapeutics or fecal microbiota transplantation, or augmentation of the host immune response with agents such as bezlotoxumab given alone or in combination (e.g., in combination with fidaxomicin) are needed," the authors write.

Several authors disclosed financial ties to the pharmaceutical industry.

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