Advances in the Medical Treatment of Clostridioides difficile Infection.

Abstract

Clostridioides difficile medical management has changed significantly over the past decade with emphasis on preventing recurrent infection. This review compares current guidelines on the treatment of initial, recurrent, fulminant, and pediatric C difficile infection (CDI) and evaluates the mechanisms and clinical use of available antibiotics for CDI. C difficile has complex resistance mechanisms to vancomycin, fidaxomicin, and metronidazole which may play a role in treatment outcomes. Antibiotics such as tigecycline and rifaximin as well as monoclonal antibodies against toxin B may play a role in adjunctive therapy. Additional therapies under development include new narrow therapeutic antibiotics.