Clostridioides difficile infection (CDI) remains a significant nosocomial threat, often linked to antibiotic exposure. Prevention through antibiotic stewardship and strict infection control is essential to reducing its incidence and healthcare impact. Broad-spectrum antibiotics like clindamycin and fluoroquinolones increase CDI risk, highlighting the need for careful prescribing. Fidaxomicin is the preferred treatment for initial and recurrent non-fulminant CDI, with oral vancomycin as an alternative. Fulminant CDI, marked by severe complications such as shock or megacolon, requires high-dose oral vancomycin, intravenous metronidazole, and timely surgical intervention.
Managing CDI in special populations, including pregnant women, children, and the elderly, demands tailored approaches. Fidaxomicin and vancomycin are safe for pregnant and postpartum patients due to minimal systemic absorption. Preventative measures, such as isolation and rigorous hygiene, remain vital in healthcare settings. For patients with multiple CDI recurrences, fecal microbiota transplantation (FMT) and adjunctive therapies like bezlotoxumab offer promising options. Comprehensive CDI care requires accurate diagnostics, effective treatments, and robust prevention strategies to minimize morbidity and improve outcomes.
Reference: Pumiglia L, Wilson L, Rashidi L. Clostridioides difficile Colitis. Surg Clin North Am. 2024 Jun;104(3):545-556. doi: 10.1016/j.suc.2023.11.005. Epub 2023 Dec 26. PMID: 38677819.
