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Updated: Feb 16, 2026
12:58
A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
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Update of treatment algorithms for Clostridium difficile infection
R E Ooijevaar1, Y H van Beurden1, E M Terveer2
1Department of Medical Microbiology and Infection Control, VU University Medical Center, Amsterdam, The Netherlands; Department of Gastroenterology and Hepatology, VU University Medical Center, Amsterdam, The Netherlands.
Summary
New treatments for Clostridium difficile infection (CDI) show promise in improving cure rates. Oral vancomycin may become the preferred antibiotic, while fecal microbiota transplantation is key for recurrent CDI.
Area of Science:
- Microbiology
- Infectious Diseases
- Gastroenterology
Background:
- Clostridium difficile infection (CDI) is a major cause of antibiotic-associated diarrhea with high recurrence rates.
- Existing treatments have limitations, prompting the development of novel therapeutic strategies.
- The European Society of Clinical Microbiology and Infectious Diseases (ESCMID) updated CDI treatment guidelines in 2014.
Purpose of the Study:
- To review emerging treatments for CDI, excluding probiotics and vaccines.
- Focus on novel antibiotics, antibiotic inactivators, monoclonal antibodies, and microbiota modulation therapies.
- Evaluate new approaches for achieving sustained clinical cure in CDI patients.
Main Methods:
- Conducted a literature review of clinical trials.
- Searched PubMed, Embase, and Cochrane Library databases.
- Included studies published between January 2013 and November 2017.
Main Results:
- Analyzed 28 clinical trials, identifying 14 novel agents.
- Phase 2 studies completed for cadazolid, LFF571, ridinilazole, and nontoxigenic C. difficile strains.
- Phase 3 trials evaluated vancomycin with bezlotoxumab, surotomycin, and rifaximin; fecal microbiota transplantation showed efficacy in multiple recurrent CDI.
Conclusions:
- Oral vancomycin is proposed as the first-choice antibiotic for CDI, surpassing metronidazole.
- Fidaxomicin is a suitable alternative, particularly for patients at risk of relapse.
- Combination therapy with vancomycin and fecal microbiota transplantation is the primary approach for multiple recurrent CDI.
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