Current treatment options for Clostridioides difficile colitis and future pro-spects

Authors: Lenka Vojtilová
Authors‘ workplace: Klinika infekčních chorob LF MU a FN Brno
Published in: Geriatrie a Gerontologie 2021, 10, č. 3: 141-146


Clostridioides difficile colitis is a leading cause of nosocomial infectious diarrhea in adults. The therapeutic challenge are frequent recurrences. The basis of therapy is antibiotic therapy and restoration of the intestinal microflora using fecal microbiota transplantation. There is a few of effective antibiotics currently available, therefore the development of new antibiotics and alternative treatment strategies has received a great attention.


fecal microbiota transplantation – Clostridioides difficile colitis – antibiotic therapy

  1. Maroo S, Lamont TJ. Reccurent Clostridium difficile. Gastroenterology 2006; 130: 1311–1316.
  2. Padua D, Pothoulakis CH. Novel approaches to treating Clostridium difficile-associated colitis. Expert Rev Gatroenterol Hepatol 2016; 10(2), 193–204.
  3. Polák P, Freibergerová M, Juránková J, et al. První zkušenosti s fekální bakterioterapií v léčbě relabující pseudomembranózní kolitidy způsobené Clostridium difficile. Klin Mikrobiol Inf Lék 2011; 17(6): 214–217.
  4. Krůtová M,  Matějková J, Nyč O. První výsledky molekulární typizace Clostridium difficile v ČR. Zprávy CEM. SZÚ; Praha 2013; 22 (12): 399–401.
  5. Debast SB, Bauer MP, Kuijper EJ. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect 2014; 20: Suppl 2: 1–26.
  6. Crobach MTJ, et al. European Society of Clinical Microbiology and Infectious Diseases: udpate of diagnostic guidance document for Clostridium difficile infection. Clinical Microbiology and Infection 2016; 22: S63–S81.
  7. Bollton RP, Culshaw MA. Fecal metronidazole concentrations during oral and intravenous therapy for antibiotic assosiated colitis due to Clostridium difficile. Gut 1986; 27: 1169–1172.
  8. Johnson S, Louie TJ, Gerding DN, et al. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: result from two multinational, randomized, controlled trials. Clin Infect Dis 2014; 59(3): 345–354.
  9. Cornely OA, Crook DW, Esposito E, et al. Fidaxomicin versus vancomycin for infection with Clostridium difficile in Europe, Canada and the USA: double-blind, non-inferiority, randomised controlled trial. Lancet Infect Dis 2012; 12: 281–289.
  10. Guery B, Menichetti F, Antilla VJ, et al. Extended-pulsed fidaxomicin versus vancomycin for Clostridium difficile infection in patients 60 years and older (EXTEND): a randomised, controlled, open-label, phase 3b/4 trial. Lancet Infect Dis 2017.
  11. Johnson S, Lavergne V, Skinner AM, et al. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clinical Infectious Diseases, ciab549.
  12. Gergely Szabo B, Kadar B, Szidonia Lenart K, et al. Use of intravenous tigecycline in patients with severe Clostridium difficile infection: a retrospective observational cohort study. Clin Microbiol Infect 2016; 22: 990–995.
  13. Kassam Z, Lee CH, Yuan Y, Hunt RH. Fecal microbiota transplantation for Clostridium difficile infection: systematic review and metaanalysis. Am J Gastroenterol 2013; 108: 500–508.
  14. Neal MD, Alverdy JC, Hall DE, et al. Diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated Clostridium difficile associated disease. Ann Surg 2011; 254: 423–429.
  15. Waltz P, Zuckerbraun B. Novel therapies for severe Clostridium difficile colitis. Curr Opin Crit Care 2016; 22(2): 167–173.
  16. Gerding DN, Cornely OA, Grill S, et al. Cadazolid for the treatment of Clostridium difficile infection: results of two double-blind, placebo-controlled, non-inferiority, randomised phase 3 trials. Lancet Infect Dis 2019; 19(3): 265–274.
  17. Boix V, Fedorak RN, Mullane KM, et al. Primary Outcomes From a Phase 3, Randomized, Double-Blind, Active-Controlled Trial of Surotomycin in Subjects With Clostridium difficile Infection. Open Forum Infect Dis 2017; 4(1): ofw275.
  18. Wilcox MH, Gerding DN, Poxton IR, et al. Bezlotoxumab for prevention of reccurent Clostridium difficile infection. N Eng J Med 2017; 376: 305–317.
  19. Villafuerte Gálvez JA, Kelly CP. Bezlotoxumab: anti-toxin B monoclonal antibody to prevent reccurence of Clostridium difficile infection. Expert Rev Gatroenterol Hepatol 2017; 11(7): 611–622.
  20. Chapin RW, Lee T, McCoy C, et al. Bezlotoxumab: Could This be the answer fo Clostridium difficile Reccurence? Ann Pharm 2017; 51(9): 804–810.
  21. Bruyn G, Gordon DL, Steiner T, et al. Safety, immunogenicity, and efficacy of a Clostridioides difficile toxoid vaccine candidate: a phase 3 multicentre, observer-blind, randomised, controlled trial. Lancet Infect Dis 2021; 21(2): 252–262.
  22. Kitchin N, Remich SA, Peterson J, et al. A Phase 2 Study Evaluating the Safety, Tolerability, and Immunogenicity of Two 3-Dose Regimens of a Clostridium difficile Vaccine in Healthy US Adults Aged 65 to 85 Years. Clin Infect Dis 2020; 70(1): 1–10.
  23. Bézay N, Ayad A, Dubischar K, et al. Safety, immunogenicity and dose response of VLA84, a new vaccine candidate against Clostridium difficile, in healthy volunteers. Vaccine 2016; 34 (23): 2585–2592.
  24. Shen NT, MAW A, Tmanova LL, et al. Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis. Gastroenterology 2017; 152(8): 1889–1900.
  25. Mills JP, Krishna R and Young VB. Probiotics for Prevention of Clostridium difficile Infection. Curr Opin Gastroenterol 2018; 34(1): 3–10.
  26. McGovern BH, Ford CB, Henn MR, et al. SER-109, an Investigational Microbiome Drug to Reduce Recurrence After Clostridioides difficile Infection: Lessons Learned From a Phase 2 Trial. Clin Infect Dis 2021; 72(12): 2132–2140.
  27. Gerding DN, Meyer T, Lee C, et al. Administration of spores of nontoxigenic Clostridium difficile strain M3 for prevention of reccurent C. difficile infection. JAMA 2015; 313: 1719.
  28. Kaleko M, Bristol JA, Hubert S, et al. Development of SYN-004, an oral beta-lactamase treatment to protect the gut microbiome from antibiotic-mediated damage and prevent Clostridium difficile infection. Anaerobe 2016; 41: 58–67.
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