Clostridium Difficile Infection: Update on Emerging Antibiotic Treatment Options and Antibiotic Resistance

Overview

Journal Expert Rev Anti Infect Ther

Specialty Infectious Diseases

Date 2010 May 12

PMID 20455684

Citations 46

Authors

Dhara Shah

Minh-Duc Dang

Rodrigo Hasbun

Hoonmo L Koo

Zhi-Dong Jiang

Herbert L DuPont

Kevin W Garey

Affiliations

Soon will be listed here.

Abstract

Clostridium difficile infection (CDI) is the most common cause of identifiable diarrhea in hospitalized patients. The incidence and severity of CDIs are increasing. The increased incidence and severity of the disease has sparked interest in the optimal treatment of CDI as well as the use of new therapies and drug discovery. Current treatment strategies are inadequate with decreased response rates to metronidazole, and high recurrence rates with the use of metronidazole and oral vancomycin. Although incidence rates continue to be low, in vitro resistance to antibiotics used for the treatment of CDI has been noted. Recently, important data has emerged on new anti-C. difficile antibiotics such as rifaximin, rifalazil, fidaxomicin, nitazoxanide, tigecycline and ramoplanin. The purpose of this review is to provide an update on the in vitro susceptibility and new antibiotic treatment options for CDI. This review will focus primarily on scientific studies published in the last 36 months in order to provide an up-to-date review on the topic.

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References

Kelly C, Lamont J . Clostridium difficile--more difficult than ever. N Engl J Med. 2008; 359(18):1932-40. DOI: 10.1056/NEJMra0707500. View

Credito K, Appelbaum P . Activity of OPT-80, a novel macrocycle, compared with those of eight other agents against selected anaerobic species. Antimicrob Agents Chemother. 2004; 48(11):4430-4. PMC: 525447. DOI: 10.1128/AAC.48.11.4430-4434.2004. View

Johnson S, Schriever C, Patel U, Patel T, Hecht D, Gerding D . Rifaximin Redux: treatment of recurrent Clostridium difficile infections with rifaximin immediately post-vancomycin treatment. Anaerobe. 2009; 15(6):290-1. DOI: 10.1016/j.anaerobe.2009.08.004. View

Louie T, Miller M, Donskey C, Mullane K, Goldstein E . Clinical outcomes, safety, and pharmacokinetics of OPT-80 in a phase 2 trial with patients with Clostridium difficile infection. Antimicrob Agents Chemother. 2008; 53(1):223-8. PMC: 2612138. DOI: 10.1128/AAC.01442-07. View

Pelaez T, Alcala L, Alonso R, Rodriguez-Creixems M, Garcia-Lechuz J, Bouza E . Reassessment of Clostridium difficile susceptibility to metronidazole and vancomycin. Antimicrob Agents Chemother. 2002; 46(6):1647-50. PMC: 127235. DOI: 10.1128/AAC.46.6.1647-1650.2002. View

Louie T, Emery J, Krulicki W, Byrne B, Mah M . OPT-80 eliminates Clostridium difficile and is sparing of bacteroides species during treatment of C. difficile infection. Antimicrob Agents Chemother. 2008; 53(1):261-3. PMC: 2612159. DOI: 10.1128/AAC.01443-07. View

Anton P, OBrien M, Kokkotou E, Eisenstein B, Michaelis A, Rothstein D . Rifalazil treats and prevents relapse of clostridium difficile-associated diarrhea in hamsters. Antimicrob Agents Chemother. 2004; 48(10):3975-9. PMC: 521872. DOI: 10.1128/AAC.48.10.3975-3979.2004. View

Zar F, Bakkanagari S, Moorthi K, Davis M . A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007; 45(3):302-7. DOI: 10.1086/519265. View

Yangco B, Sher G, Bardin M . Nitazoxanide and probiotics for the treatment of recurrent Clostridium difficile infection in a peritoneal dialysis patient. South Med J. 2009; 102(7):746-7. DOI: 10.1097/SMJ.0b013e3181a82bbb. View

10.

Lagrotteria D, Holmes S, Smieja M, Smaill F, Lee C . Prospective, randomized inpatient study of oral metronidazole versus oral metronidazole and rifampin for treatment of primary episode of Clostridium difficile-associated diarrhea. Clin Infect Dis. 2006; 43(5):547-52. DOI: 10.1086/506354. View

11.

Barbut F, Mastrantonio P, Delmee M, Brazier J, Kuijper E, Poxton I . Prospective study of Clostridium difficile infections in Europe with phenotypic and genotypic characterisation of the isolates. Clin Microbiol Infect. 2007; 13(11):1048-57. DOI: 10.1111/j.1469-0691.2007.01824.x. View

12.

Jung S, Jeon S, Do B, Kim S, Ha S, Cho C . Clinical aspects of rifampicin-associated pseudomembranous colitis. J Clin Gastroenterol. 2007; 41(1):38-40. DOI: 10.1097/MCG.0b013e31802dfaf7. View

13.

Citron D, Merriam C, Tyrrell K, Warren Y, Fernandez H, Goldstein E . In vitro activities of ramoplanin, teicoplanin, vancomycin, linezolid, bacitracin, and four other antimicrobials against intestinal anaerobic bacteria. Antimicrob Agents Chemother. 2003; 47(7):2334-8. PMC: 161871. DOI: 10.1128/AAC.47.7.2334-2338.2003. View

14.

McVay C, Rolfe R . In vitro and in vivo activities of nitazoxanide against Clostridium difficile. Antimicrob Agents Chemother. 2000; 44(9):2254-8. PMC: 90054. DOI: 10.1128/AAC.44.9.2254-2258.2000. View

15.

SWANSON R, Hardy D, Shipkowitz N, Hanson C, Ramer N, Fernandes P . In vitro and in vivo evaluation of tiacumicins B and C against Clostridium difficile. Antimicrob Agents Chemother. 1991; 35(6):1108-11. PMC: 284295. DOI: 10.1128/AAC.35.6.1108. View

16.

OConnor J, Galang M, Sambol S, Hecht D, Vedantam G, Gerding D . Rifampin and rifaximin resistance in clinical isolates of Clostridium difficile. Antimicrob Agents Chemother. 2008; 52(8):2813-7. PMC: 2493101. DOI: 10.1128/AAC.00342-08. View

17.

Baines S, OConnor R, Freeman J, Fawley W, Harmanus C, Mastrantonio P . Emergence of reduced susceptibility to metronidazole in Clostridium difficile. J Antimicrob Chemother. 2008; 62(5):1046-52. DOI: 10.1093/jac/dkn313. View

18.

Nord C, Sillerstrom E, Wahlund E . Effect of tigecycline on normal oropharyngeal and intestinal microflora. Antimicrob Agents Chemother. 2006; 50(10):3375-80. PMC: 1610089. DOI: 10.1128/AAC.00373-06. View

19.

Johnson S, Schriever C, Galang M, Kelly C, Gerding D . Interruption of recurrent Clostridium difficile-associated diarrhea episodes by serial therapy with vancomycin and rifaximin. Clin Infect Dis. 2007; 44(6):846-8. DOI: 10.1086/511870. View

20.

Citron D, Babakhani F, Goldstein E, Nagaro K, Sambol S, Sears P . Typing and susceptibility of bacterial isolates from the fidaxomicin (OPT-80) phase II study for C. difficile infection. Anaerobe. 2009; 15(6):234-6. DOI: 10.1016/j.anaerobe.2009.09.005. View