Review
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Sep 5, 2024; 15(5): 95467
Published online Sep 5, 2024. doi: 10.4292/wjgpt.v15.i5.95467
Therapeutics involved in managing initial and recurrent Clostridium difficile infection: An updated literature review
Vignesh K Nagesh, Hadrian Hoang-Vu Tran, Daniel Elias, Izage Kianifar Aguilar, Tanni Sethi, Aiswarya Menon, Charlene Mansour, Florchi Furman, Kylie Tsotsos, Talia Subar, Auda Auda, Aman Sidiqui, Jevon Lamar, Nikita Wadhwani, Shraboni Dey, Abraham Lo, Adam Atoot, Simcha Weissman, Humberto Sifuentes, Ayrton I Bangolo
Vignesh K Nagesh, Hadrian Hoang-Vu Tran, Daniel Elias, Izage Kianifar Aguilar, Tanni Sethi, Aiswarya Menon, Charlene Mansour, Florchi Furman, Kylie Tsotsos, Talia Subar, Auda Auda, Aman Sidiqui, Jevon Lamar, Nikita Wadhwani, Shraboni Dey, Abraham Lo, Adam Atoot, Simcha Weissman, Ayrton I Bangolo, Department of Internal Medicine, Hackensack Palisades Medical Center, North Bergen, NJ 07047, United States
Humberto Sifuentes, Department of Gastroenterology, Augusta University, Augusta, GA 30912, United States
Co-corresponding authors: Vignesh K Nagesh and Ayrton I Bangolo.
Author contributions: Nagesh VK, Tran HHV, Elias D, Aguilar IK, Sethi T, Menon A, Mansour C, Furman F, Tsotsos K, Subar T, Auda A, Siddiqui A, Lamar J, Wadhwani N, Dey S, Lo A, Atoot A, searched the literature, wrote and revised the manuscript; Weissman S, Sifuentes H, Bangolo AI supervised the project; All authors certify that they contributed by sufficiently searching the literature, writing and revising the manuscript, contributed to the intellectual content and data analysis; Each author has reviewed the final version of the manuscript and approved it for publication.
Conflict-of-interest statement: No potential conflict of interest was reported by the authors.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Vignesh K Nagesh, MBBS, MD, Doctor, Department of Internal Medicine, Hackensack Palisades Medical Center, 7600 River Road, North Bergen, NJ 07047, United States. vgneshkrishnan@gmail.com
Received: April 11, 2024
Revised: July 21, 2024
Accepted: July 25, 2024
Published online: September 5, 2024
Processing time: 145 Days and 7 Hours
Abstract

Clostridium difficile infection (CDI) has been increasing due to the effect of recurrent hospitalizations. The use of antibiotics has been shown to alter the gut microbiome and lead to CDIs. The treatment is limited to three major antibiotics; however, the incidence of recurrent CDIs has been increasing and drug resistance is a major concern. This aspect is a growing concern in modern medicine especially in the elderly population, critical care patients, and immunocompromised individuals who are at high risk of developing CDIs. Clostridium difficile can lead to various complications including septic shock and fulminant colitis that could prove to be lethal in these patients. Newer modalities of treatment have been developed including bezlotoxumab, a monoclonal antibody and fecal microbiota transplant. There have been studies showing asymptomatic carriers and drug resistance posing a major threat to the healthcare system. Newer treatment options are being studied to treat and prevent CDIs. This review will provide an insight into the current treatment modalities, prevention and newer modalities of treatment and challenges faced in the treatment of CDIs.

Keywords: Clostridium difficile; Antibiotics; Vancomycin; Fidaxomicin; Prevention; Bezlotoxumab; Fecal microbiota transplant

Core Tip: Clostridium difficile infections (CDIs) are one of the most common of hospital acquired infections and are caused by the use of antibiotics. The treatment is limited to 3 antibiotics currently. There has been a rise in recurrent CDIs. Our review aims to provide an overview of current testing and treatment modalities, prevention, new treatment options, challenges and current studies in the aspect of CDIs, which has become a growing concern to global health.