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https://www.readbyqxmd.com/read/29336930/exploring-ways-to-improve-cdi-outcomes
#1
REVIEW
T Galpérine, B Guery
Clostridium difficile is an anaerobic spore-forming Gram-positive bacillus recognized as an evolving international health problem. Metronidazole and vancomycin were - until recently - the only drugs available to treat C. difficile infection (CDI). Better knowledge of the pathophysiology and the development of new drugs completely modified the management of initial episodes and recurrences of CDI. Fidaxomicin significantly reduced recurrences compared with vancomycin. New drugs are also currently evaluated (cadazolid, surotomycin, ridinilazole, rifaximin)...
January 11, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29336929/economic-burden-and-cost-effective-management-of-clostridium-difficile-infections
#2
REVIEW
S M Heimann, M R Cruz Aguilar, S Mellinghof, M J G T Vehreschild
Clostridium difficile infection (CDI) is the most important cause of healthcare-associated infectious diarrhea in industrialized countries. We performed a literature review of the overall economic burden of initial and recurrent CDI as well as of the cost-effectiveness of the various treatment strategies applied in these settings. Even though analysis of health economic data is complicated by the limited comparability of results, our review identified several internationally consistent results. Authors from different countries have shown that recurrent CDI disproportionally contributes to the overall economic burden of CDI and therefore offers considerable saving potential...
January 11, 2018: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29309934/update-of-treatment-algorithms-for-clostridium-difficile-infection
#3
REVIEW
R E Ooijevaar, Y H van Beurden, E M Terveer, A Goorhuis, M P Bauer, J J Keller, C J J Mulder, E J Kuijper
BACKGROUND: Clostridium difficile is the leading cause of antibiotic-associated diarrhea, both in healthcare facilities and the community. The recurrence rate of C. difficile infection (CDI) remains high, up to 20%. Since the publication of the ESCMID guidance document on CDI treatment in 2014, new therapeutic approaches have been developed and tested to achieve higher sustained clinical cure in CDI. AIM: To review novel treatments and approaches for CDI, except probiotics and vaccines...
January 5, 2018: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29273269/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
#4
Benoit Guery, Francesco Menichetti, Veli-Jukka Anttila, Nicholas Adomakoh, Jose Maria Aguado, Karen Bisnauthsing, Areti Georgopali, Simon D Goldenberg, Andreas Karas, Gbenga Kazeem, Chris Longshaw, Jose Alejandro Palacios-Fabrega, Oliver A Cornely, Maria J G T Vehreschild
BACKGROUND: Clostridium difficile infection causes severe complications and frequently recurs. An extended-pulsed fidaxomicin regimen might facilitate sustained clinical cure by prolonging C difficile suppression and supporting gut microbiota recovery. We aimed to compare clinical outcomes of extended-pulsed fidaxomicin with standard vancomycin. METHODS: In this randomised, controlled, open-label, superiority study, we recruited hospitalised adults aged 60 years and older with confirmed C difficile infection at 86 European hospitals...
December 19, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29261736/randomized-clinical-trial-to-evaluate-the-effect-of-fecal-microbiota-transplant-for-initial-clostridium-difficile-infection-in-intestinal-microbiome
#5
Adrián Camacho-Ortiz, Eva María Gutiérrez-Delgado, Jose F Garcia-Mazcorro, Soraya Mendoza-Olazarán, Adrián Martínez-Meléndez, Laura Palau-Davila, Simon D Baines, Héctor Maldonado-Garza, Elvira Garza-González
OBJECTIVE: The aim of this study was to evaluate the impact of fecal donor-unrelated donor mix (FMT-FURM) transplantation as first-line therapy for C. difficile infection (CDI) in intestinal microbiome. METHODS: We designed an open, two-arm pilot study with oral vancomycin (250mg every 6 h for 10-14 days) or FMT-FURM as treatments for the first CDI episode in hospitalized adult patients in Hospital Universitario "Dr. Jose Eleuterio Gonzalez". Patients were randomized by a closed envelope method in a 1: 1 ratio to either oral vancomycin or FMT-FURM...
2017: PloS One
https://www.readbyqxmd.com/read/29227855/a-case-report-of-successful-management-of-clostridium-difficile-colitis-with-antegrade-fidaxomicin-through-a-mucous-fistula-obviating-the-need-for-subtotal-colectomy
#6
Suzanne Arnott, Matthew Skancke, Sheena Chen, Bruce Abell
INTRODUCTION: Clostridium difficile is the most common cause of healthcare-associated infections and can have devastating morbidity and mortality. Traditional treatment algorithms involve intravenous metronidazole and enteric metronidazole or vancomycin. Fidaxomicin (DificidR) targets "switch regions" within RNA polymerases and effectively kills clostridium difficile bacteria and is typically administered orally primarily or through a naso/oro-gastric conduit. PRESENTATION OF CASE: 55-year-old with a recent elective surgical procedure was hospitalized with multifocal pneumonia and subsequently developed clostridium difficile colitis...
November 27, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/29208562/microbiological-factors-affecting-clostridium-difficile-recurrence
#7
REVIEW
C H Chilton, D S Pickering, J Freeman
BACKGROUND: Recurrent Clostridium difficile infection (rCDI) places a huge economic and practical burden on healthcare facilities. Furthermore, rCDI may impact quality of life, leaving patients in a 'rCDI cycle', and dependant on antibiotic therapy. AIMS: This article discusses the importance of microbiological factors in the development of rCDI. SOURCES: Literature was drawn from a search of PubMed from 2000 onwards with the search term "recurrent Clostridium difficile infection"; and further references quoted within these articles...
December 2, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29169816/existing-and-investigational-therapies-for-the-treatment-of-clostridium-difficile-infection-a-focus-on-narrow-spectrum-microbiota-sparing-agents
#8
REVIEW
H G Maxwell-Scott, S D Goldenberg
Despite intense international attention and efforts to reduce its incidence, Clostridium difficile infection (CDI) remains a significant concern for patients, clinicians, and healthcare organizations. It is costly for payers and disabling for patients. Furthermore, recurrent CDI is particularly difficult to manage, resulting in excess mortality, hospital length of stay, and other healthcare resource use. A greater understanding of the role of the gut microbiome has emphasized the importance of this diverse community in providing colonization resistance against CDI...
November 20, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/29123385/clostridium-difficile-infection-in-the-elderly-an-update-on-management
#9
REVIEW
Tomefa E Asempa, David P Nicolau
The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care-associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care-associated CDIs occur in patients 65 years or older...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/29101931/safety-and-efficacy-of-fecal-microbiota-transplant-for-recurrent-clostridium-difficile-infection-in-patients-with-cancer-treated-with-cytotoxic-chemotherapy-a-single-institution-retrospective-case-series
#10
Mehrdad Hefazi, Mrinal M Patnaik, William J Hogan, Mark R Litzow, Darrell S Pardi, Sahil Khanna
OBJECTIVE: To study the safety and efficacy of fecal microbiota transplant (FMT) for Clostridium difficile infection (CDI) in patients with cancer treated with cytotoxic chemotherapy in a single-institution retrospective case series. PATIENTS AND METHODS: Twenty-three consecutive patients with underlying hematologic (n=13) or solid (n=10) malignancies who underwent FMT for recurrent CDI from August 1, 2012, through June 30, 2016, were studied. RESULTS: All the patients had received cytotoxic chemotherapy a median of 12 months (range, 1-340 months) before FMT...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29089778/treatment-of-pediatric-clostridium-difficile-infection-a-review-on-treatment-efficacy-and-economic-value
#11
REVIEW
Amanda R D'Ostroph, Tsz-Yin So
The incidence of Clostridium difficile infection (CDI) in pediatric patients continues to rise. Most of the pediatric recommendations for CDI treatment are extrapolated from the literature and guidelines for adults. The American Academy of Pediatrics recommends oral metronidazole as the first-line treatment option for an initial CDI and the first recurrence if they are mild to moderate in severity. Oral vancomycin is recommended to be used for severe CDI and the second recurrent infection. Additional pulsed regimen of oral vancomycin, which is tapered, may increase efficacy in refractory patients...
2017: Infection and Drug Resistance
https://www.readbyqxmd.com/read/29066403/the-closer-study-results-from-a-three-year-pan-european-longitudinal-surveillance-of-antibiotic-resistance-among-prevalent-clostridium-difficile-ribotypes-2011-2014
#12
Jane Freeman, Jonathan Vernon, Sally Pilling, Kirsti Morris, Scott Nicholson, Sharie Shearman, Chris Longshaw, Mark H Wilcox
OBJECTIVES: Until the introduction of fidaxomicin, antimicrobial treatment for Clostridium difficile infection (CDI) was limited to metronidazole and vancomycin. The changing epidemiology of CDI and emergence of epidemic C. difficile PCR ribotype 027 necessitates continued surveillance to identify shifts in antibiotic susceptibility. ClosER, currently the largest pan-European epidemiological study of C. difficile ribotype distribution and antibiotic susceptibility, aimed to undertake antimicrobial resistance surveillance pre- and post-introduction of fidaxomicin...
October 21, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/29044643/fidaxomicin-versus-vancomycin-as-a-first-line-treatment-for-clostridium-difficile-associated-diarrhea-cdad-in-specific-patient-populations-a-pharmacoeconomic-evaluation
#13
Kelly R Reveles, Jennifer L Backo, Frank A Corvino, Marko Zivkovic, Kelly C Broderick
OBJECTIVES: The reduction in recurrent Clostridium difficile-associated diarrhea (CDAD) with fidaxomicin therapy may reduce hospital readmissions and lead to lower overall CDAD costs. However, studies assessing the cost-effectiveness of fidaxomicin as first-line therapy from the United States (US) hospital perspective are lacking. This study evaluated the costs associated with utilizing fidaxomicin or vancomycin as a first-line therapy for CDAD in specific patient populations from a US hospital perspective...
October 17, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29038278/fidaxomicin-and-op-1118-inhibit-c-difficile-toxin-a-and-b-mediated-inflammatory-responses-via-inhibition-of-nf-%C3%AE%C2%BAb-activity
#14
Hon Wai Koon, Jiani Wang, Caroline C Mussatto, Christina Ortiz, Elaine C Lee, Diana Hoang-Ngoc Tran, Xinhua Chen, Ciaran P Kelly, Charalabos Pothoulakis
Objective:Clostridium difficile causes diarrhea and colitis by releasing toxin A and toxin B. In the human colon, both toxins cause intestinal inflammation and stimulate TNFα expression via activation of NF-κB. It is well established that the macrolide antibiotic fidaxomicin is associated with reduced relapses of C. difficile infection. We showed that fidaxomicin and its primary metabolite, OP-1118, significantly inhibited toxin A-mediated intestinal inflammation in mice in vivo and toxin A-induced cell rounding in vitro We aim to determine whether fidaxomicin and OP-1118 possess anti-inflammatory effects against toxin A and toxin B in the human colon and examine the mechanism of this response...
October 16, 2017: Antimicrobial Agents and Chemotherapy
https://www.readbyqxmd.com/read/29029221/analysis-of-clostridium-difficile-biofilms-imaging-and-antimicrobial-treatment
#15
Garth A James, Laurent Chesnel, Laura Boegli, Elinor deLancey Pulcini, Steve Fisher, Philip S Stewart
Background: Clostridium difficile, a spore-forming Gram-positive anaerobic bacillus, is the most common causative agent of healthcare-associated diarrhoea. Formation of biofilms may protect C. difficile against antibiotics, potentially leading to treatment failure. Furthermore, bacterial spores or vegetative cells may linger in biofilms in the gut causing C. difficile infection recurrence. Objectives: In this study, we evaluated and compared the efficacy of four antibiotics (fidaxomicin, surotomycin, vancomycin and metronidazole) in penetrating C...
January 1, 2018: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29026601/complications-effectiveness-and-long-term-follow-up-of-fecal-microbiota-transfer-by-nasoduodenal-tube-for-treatment-of-recurrent-clostridium-difficile-infection
#16
Yvette H van Beurden, Pieter F de Groot, Els van Nood, Max Nieuwdorp, Josbert J Keller, Abraham Goorhuis
BACKGROUND: Fecal microbiota transfer (FMT) is an effective treatment for recurrent Clostridium difficile infection (CDI), but data on procedure-related complications and long-term outcome are scarce. METHODS: All patients treated with FMT for recurrent CDI at the Academic Medical Center between July 2010 and January 2016 were included. FMT was performed according to the FECAL trial protocol: administration of fresh donor feces (related or unrelated donor) through a duodenal tube after pre-treatment with vancomycin and bowel lavage...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28893366/fidaxomicin-reduces-early-toxin-a-and-b-production-and-sporulation-in-clostridium-difficilein-vitro
#17
Michael J Aldape, Aaron E Packham, Dustin D Heeney, Savannah N Rice, Amy E Bryant, Dennis L Stevens
PURPOSE: Fidaxomicin, a macrocyclic antibiotic, has been approved for the treatment of Clostridium difficile infection (CDI). Previous work by our group has demonstrated that some antibiotics at sub-inhibitory concentrations stimulate early toxin production and sporulation by C. difficile. Prior studies revealed that fidaxomicin, when added to late stationary-phase organisms, reduced exotoxin production and spore formation by C. difficile. However, the ability of fidaxomicin to trigger early virulence factor production and spore formation has never been investigated...
October 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/28875314/a-systematic-literature-review-of-economic-evaluations-of-antibiotic-treatments-for-clostridium-difficile-infection
#18
REVIEW
Hannah E Burton, Stephen A Mitchell, Maureen Watt
BACKGROUND AND OBJECTIVE: Clostridium difficile infection (CDI) is associated with high management costs, particularly in recurrent cases. Fidaxomicin treatment results in lower recurrence rates than vancomycin and metronidazole, but has higher acquisition costs in Europe and the USA. This systematic literature review summarises economic evaluations (EEs) of fidaxomicin, vancomycin and metronidazole for treatment of CDI. METHODS: Electronic databases (MEDLINE(®), Embase, Cochrane Library) and conference proceedings (ISPOR, ECCMID, ICAAC and IDWeek) were searched for publications reporting EEs of fidaxomicin, vancomycin and/or metronidazole in the treatment of CDI...
November 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28797834/antibiotic-susceptibility-of-probiotic-strains-is-it-reasonable-to-combine-probiotics-with-antibiotics
#19
C Neut, S Mahieux, L J Dubreuil
OBJECTIVE: The main goal of this study was to determine the in vitro susceptibility of strains collected from marketed probiotics to antibiotics used to treat community-acquired infections. METHODS: The minimum inhibitory concentrations (MICs) of 16 antibiotics were determined using a gradient strip (E test) or the agar dilution method for fidaxomicin. RESULTS: The probiotics demonstrated various antibiotic patterns. Bacterial probiotics are generally susceptible to most prescribed antibiotics orally administered, whereas yeast probiotics, such as Saccharomyces boulardii, are resistant...
November 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28760934/next-generation-probiotics-targeting-clostridium-difficile-through-precursor-directed-antimicrobial-biosynthesis
#20
Jennifer K Spinler, Jennifer Auchtung, Aaron Brown, Prapaporn Boonma, Numan Oezguen, Caná L Ross, Ruth Ann Luna, Jessica Runge, James Versalovic, Alex Peniche, Sara M Dann, Robert A Britton, Anthony Haag, Tor C Savidge
Integration of antibiotic and probiotic therapy has the potential to lessen the public health burden of antimicrobial-associated diseases. Clostridium difficile infection (CDI) represents an important example where the rational design of next-generation probiotics is being actively pursued to prevent disease recurrence. Because intrinsic resistance to clinically relevant antibiotics used to treat CDI (vancomycin, metronidazole, and fidaxomicin) is a desired trait in such probiotic species, we screened several bacteria and identified Lactobacillus reuteri to be a promising candidate for adjunct therapy...
October 2017: Infection and Immunity
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