[Treatment of infections associated with Clostridium difficile]

Abstract

Cases of antibiotic-associated diarrhoea (AAD) associated with toxigenic C. difficile strains more frequently are described recently. In Polish studies diagnosis of AAD or PMC (pseudomembranous colitis) was confirmed by isolation of C. difficile strains in 52% of suspected cases. Strains of C. difficile were isolated also from samples taken from hospital environment (10.5% positive samples). Problem of C. difficile-associated infection is more frequently observed in Poland also because of uncontrolled using of wide spectrum antibiotics. These antibiotics destroy intestinal microflora--"colonization resistance factor". Cases of AAD or PMC were described even after treatment of patients by vancomycin or metronidazol--antibiotics of choice for treatment of C. difficile-associated diseases. Other risk factors as: age, long term hospitalization, previous surgery, colonoscopy are also taken into account, when C. difficile-associated infections are suspected. Different treatment methods of C. difficile-associated infections are reviewed here and discussed in light of recent publications.