European Society of Clinical Microbiology and Infectious Diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults

作者：Joffrey van Prehn, Elena Reigadas, Erik Hans Vogelzang, Emilio Bouza, Adriana Hristea, Benoit P. Guery, Marcela Krůtová, Torbjörn Norén, Franz J. Allerberger, John Eugenio Coia, Abraham Goorhuis, Tessel Meike van Rossen, Rogier E. Ooijevaar, Karen Burns, Bente Ruth Scharvik Olesen, Sarah Tschudin‐Sutter, Mark H. Wilcox, Maria J. G. T. Vehreschild, Fidelma Fitzpatrick, Ed J. Kuijper · 发表于：Clinical Microbiology and Infection · 年份：2021 · DOI：10.1016/j.cmi.2021.09.038 · 被引用次数：637 · 研究领域：Clostridium difficile and Clostridium perfringens research、Antibiotic Use and Resistance、Bacterial Identification and Susceptibility Testing

SCOPE: In 2009, the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published the first treatment guidance document for Clostridioides difficile infection (CDI). This document was updated in 2014. The growing literature on CDI antimicrobial treatment and novel treatment approaches, such as faecal microbiota transplantation (FMT) and toxin-binding monoclonal antibodies, prompted the ESCMID study group on C. difficile (ESGCD) to update the 2014 treatment guidance document for CDI in adults. METHODS AND QUESTIONS: Key questions on CDI treatment were formulated by the guideline committee and included: What is the best treatment for initial, severe, severe-complicated, refractory, recurrent and multiple recurrent CDI? What is the best treatment when no oral therapy is possible? Can prognostic factors identify patients at risk for severe and recurrent CDI and is there a place for CDI prophylaxis? Outcome measures for treatment strategy were: clinical cure, recurrence and sustained cure. For studies on surgical interventions and severe-complicated CDI the outcome was mortality. Appraisal of available literature and drafting of recommendations was performed by the guideline drafting group. The total body of evidence for the recommendations on CDI treatment consists of the literature described in the previous guidelines, supplemented with a systematic literature search on randomized clinical trials and observational studies from 2012 and onwards. The Grades ...