Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2018 Feb;6(1):21-28.
doi: 10.1093/gastro/gox041. Epub 2017 Dec 18.

Treatment of recurrent Clostridium difficile colitis: a narrative review

Roy J Hopkins  1 , Robert B Wilson  1
Affiliations
Review

Treatment of recurrent Clostridium difficile colitis: a narrative review

Roy J Hopkins et al. Gastroenterol Rep (Oxf). 2018 Feb.

Abstract

Clostridium difficile is a gram-positive, spore-forming, obligate anaerobic bacillus that was originally isolated from the stool of a healthy neonate in 1935. In high-income countries, C. difficile is the most common cause of infectious diarrhoea in hospitalized patients. The incidence of C. difficile infection in the USA has increased markedly since 2000, with hospitalizations for C. difficile infections in non-pregnant adults doubling between 2000 and 2010. Between 20% and 35% of patients with C. difficile infection will fail initial antibiotic treatment and, of these, 40-60% will have a second recurrence. Recurrence of C. difficile infection after initial treatment causes substantial morbidity and is a major burden on health care systems. In this article, current treatments for recurrent C. difficile infection are reviewed and future directions explored. These include the use of antibiotics, probiotics, donor faecal transplants, anion resins, secondary bile acids or anti-toxin antibodies.

Keywords: Clostridium difficile; anion-binding resins; faecal microbiota transplant; monoclonal antibodies; recurrent infection; secondary bile acid.

PubMed Disclaimer

References

    1. Hall IC, O’Toole E.. Intestinal flora in new-born infants: with a description of a new pathogenic anaerobe, Bacillius difficilis. Am J Dis Child 1935;49:390–402.
    1. Bartlett JG, Chang TW, Gurwith M. et al. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 1978;298:531–4. - PubMed
    1. Magill SS, Edwards JR, Bamberg W. et al.; Emerging Infections Program Healthcare-Associated Infections and Antimicrobial Use Prevalence Survey Team. Multistate point-prevalence survey of health care-associated infections. N Engl J Med 2014;370:1198–208. - PMC - PubMed
    1. Rupnik M, Wilcox MH, Gerding DN.. Clostridium difficile infection: new developments in epidemiology and pathogenesis. Nat Rev Microbiol 2009;7:526–36. - PubMed
    1. Best EL, Fawley WN, Parnell P. et al. The potential for airborne dispersal of Clostridium difficile from symptomatic patients. Clin Infect Dis 2010;50:1450–7. - PubMed