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
. 2022 Sep 14;11(9):1247.
doi: 10.3390/antibiotics11091247.

Is Three Company or a Crowd? Comparing and Contrasting U.S. and European Clostridioidesdifficile Clinical Practice Guidelines

Jordan Jones  1 , Aditya Pradhan  1 , Morgan E Pizzuti  2 , Christopher M Bland  3 , P Brandon Bookstaver  1   2
Affiliations
Review

Is Three Company or a Crowd? Comparing and Contrasting U.S. and European Clostridioidesdifficile Clinical Practice Guidelines

Jordan Jones et al. Antibiotics (Basel). .

Abstract

In 2021, the American College of Gastroenterology (ACG), the Infectious Diseases Society of America in conjunction with the Society for Healthcare Epidemiology of America (IDSA/SHEA), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published updated clinical practice guidelines (CPGs) for the management of Clostridioides difficile infections. The differences, sometimes subtle, between these guideline recommendations have caused some debate among clinicians. This paper delves into select key recommendations from each respective CPG and analyzes the differences and evidence associated with each. One primary difference between the CPGs is the preference given to fidaxomicin over vancomycin for initial treatment in non-severe and severe disease endorsed by IDSA/SHEA and ESCMID guidelines, while the ACG-sponsored CPGs do not offer a preference. The emphasis on cost effective data was also a noticeable difference between the CPGs and thus interpretation of the available evidence. When using guidelines to help support local practice or institutional treatment pathways, clinicians should carefully balance CPG recommendations with local patient populations and feasibility of implementation, especially when multiple guidelines for the same disease state exist.

Keywords: ACG; Clostridioides difficile; ESCMID; FMT; IDSA; bezlotoxumab; fidaxomicin; guidelines; vancomycin.

PubMed Disclaimer

Conflict of interest statement

Christopher M. Bland is a consultant and on speaker's bureau for Merck Pharmaceuticals. No other authors declare a conflict of interest.

References

    1. Lessa F.C., Mu Y., Bamberg W.M., Beldavs Z.G., Dumyati G.K., Dunn J.R., Farley M.M., Holzbauer S.M., Meek J.I., Phipps E.C., et al. Burden of Clostridium difficile infection in the United States. N. Engl. J. Med. 2015;372:825–834. doi: 10.1056/NEJMoa1408913. - DOI - PMC - PubMed
    1. Centers for Disease Control and Prevention (U.S.) Antibiotic Resistance Threats in the United States, 2019. Centers for Disease Control and Prevention (U.S.); Atlanta, GA, USA: 2019.
    1. Shrestha M.P., Bime C., Taleban S. Decreasing Clostridium difficile-Associated Fatality Rates Among Hospitalized Patients in the United States: 2004–2014. Am. J. Med. 2018;131:90–96. doi: 10.1016/j.amjmed.2017.07.022. - DOI - PubMed
    1. Mollard S., Lurienne L., Heimann S.M., Bandinelli P.-A. Burden of Clostridium (Clostridioides) difficile infection during inpatient stays in the USA between 2012 and 2016. J. Hosp. Infect. 2019;102:135–140. doi: 10.1016/j.jhin.2019.01.020. - DOI - PubMed
    1. Aslam S., Hamill R.J., Musher D.M. Treatment of Clostridium difficile-associated disease: Old therapies and new strategies. Lancet Infect. Dis. 2005;5:549–557. doi: 10.1016/S1473-3099(05)70215-2. - DOI - PubMed

LinkOut - more resources