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Review
. 2024 Apr 20:72:102604.
doi: 10.1016/j.eclinm.2024.102604. eCollection 2024 Jun.

Guideline for the management of Clostridioides difficile infection in pediatric patients with cancer and hematopoietic cell transplantation recipients: 2024 update

Priya Patel  1   2 , Paula D Robinson  1 , Brian T Fisher  3 , Robert Phillips  4   5 , Jessica E Morgan  4   5 , Thomas Lehrnbecher  6 , Susan Kuczynski  7 , Christa Koenig  8 , Gabrielle M Haeusler  9 , Adam Esbenshade  10 , Caitlin Elgarten  11 , Nathan Duong  7 , Caroline Diorio  11 , Elio Castagnola  12 , Melissa P Beauchemin  13 , Roland A Ammann  14   15 , L Lee Dupuis  2   16   17 , Lillian Sung  16   18
Affiliations
Review

Guideline for the management of Clostridioides difficile infection in pediatric patients with cancer and hematopoietic cell transplantation recipients: 2024 update

Priya Patel et al. EClinicalMedicine. .

Abstract

Our objective was to update a clinical practice guideline for the prevention and treatment of Clostridioides difficile infection (CDI) in pediatric patients with cancer and hematopoietic cell transplantation recipients. We reconvened an international multi-disciplinary panel. A systematic review of randomized controlled trials (RCTs) for the prevention or treatment of CDI in any population was updated and identified 31 new RCTs. Strong recommendations were made to use either oral metronidazole or oral vancomycin for non-severe CDI treatment, and to use either oral vancomycin or oral fidaxomicin for severe CDI. A strong recommendation that fecal microbiota transplantation should not be routinely used to treat CDI was also made. The panel made two new good practice statements to follow infection control practices including isolation in patients experiencing CDI, and to minimize systemic antibacterial administration where feasible, especially in patients who have experienced CDI.

Keywords: Clostridioides difficile infection; Pediatric oncology; Practice guideline; Prevention; Treatment.

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Conflict of interest statement

BTF has served on a data safety monitoring board for Astellas and BTF's institution has received grant support from Allovir and Pfizer as well as CDC, FDA and NIH for research performed. CD has received support from Abramson Cancer Center K12 and a CIHR Fellowship Award. TL's institution has received an unrestricted research grant by Gilead Sciences and TL has received payments or honoraria for lectures, presentations, speakers bureaus, manuscript writing or educational events from: Astra Zeneca, EUSA Pharma, Gilead Sciences, MSD/Merck and Pfizer. TL has received support for attending meetings and/or travel from EUSA Pharma and has served on a data safety monitoring board or advisory board for: EUSA Pharma, Gilead Sciences, Merck/MSD, Mundipharma, Pfizer and Pharming. TL has had a leadership or fiduciary role in other board, society, committee or advocacy group, paid or unpaid at: Working Party Infection German Society of Pediatric Oncology and Hematology and Working Party Infection German Society of Pediatric Infectious Diseases. LS is supported by the Canada Research Chair in Pediatric Oncology Supportive Care. No other authors declared a conflict of interest.

References

    1. Sammons J.S., Toltzis P., Zaoutis T.E. Clostridium difficile Infection in children. JAMA Pediatr. 2013;167(6):567–573. - PubMed
    1. Liu C., Monaghan T., Yadegar A., Louie T., Kao D. Insights into the evolving epidemiology of Clostridioides difficile infection and treatment: a global perspective. Antibiotics (Basel) 2023;12(7):1141. - PMC - PubMed
    1. de Blank P., Zaoutis T., Fisher B., Troxel A., Kim J., Aplenc R. Trends in Clostridium difficile infection and risk factors for hospital acquisition of Clostridium difficile among children with cancer. J Pediatr. 2013;163(3):699–705.e1. - PMC - PubMed
    1. Kim J., Shaklee J.F., Smathers S., et al. Risk factors and outcomes associated with severe clostridium difficile infection in children. Pediatr Infect Dis J. 2012;31(2):134–138. - PubMed
    1. Gerding D.N., Johnson S., Peterson L.R., Mulligan M.E., Silva J., Jr. Clostridium difficile-associated diarrhea and colitis. Infect Control Hosp Epidemiol. 1995;16(8):459–477. - PubMed