scholarly journals Experience and Outcomes at a Specialized Clostridium difficile Clinical Practice

2017 ◽  
Vol 1 (1) ◽  
pp. 49-56 ◽  
Author(s):  
Raseen Tariq ◽  
Renee M. Weatherly ◽  
Patricia P. Kammer ◽  
Darrell S. Pardi ◽  
Sahil Khanna
Keyword(s):  
Clinical Practice ◽  
Clostridium Difficile

scholarly journals ID Learning Unit: Understanding and Interpreting Testing for Clostridium difficile

2014 ◽  
Vol 1 (1) ◽  
Author(s):  
Daniel A. Solomon ◽  
Danny A. Milner
Keyword(s):  
Clinical Practice ◽  
Clostridium Difficile ◽  
Basic Principles ◽  
Multiple Tests ◽  
Molecular Tests ◽  
Different Types

Abstract Understanding and interpreting the molecular tests for Clostridium difficile is challenging because there are several different types of assays and most laboratories combine multiple tests in order to assess for presence of disease. This learning unit demonstrates the basic principles of each test along with its strengths and weaknesses, and illustrates how the tests are used in clinical practice.

scholarly journals Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)

2018 ◽  
Vol 66 (7) ◽  
pp. 987-994 ◽  
Author(s):  
L Clifford McDonald ◽  
Dale N Gerding ◽  
Stuart Johnson ◽  
Johan S Bakken ◽  
Karen C Carroll ◽  
...  
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Clostridium Difficile ◽  
Infectious Diseases ◽  
Clostridium Difficile Infection ◽  
The United States ◽  
Healthcare Associated Infection ◽  
Adults And Children ◽  
Healthcare Associated ◽  
Healthcare Epidemiology

Abstract A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. The update, which has incorporated recommendations for children (following the adult recommendations for epidemiology, diagnosis, and treatment), includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis. Clostridium difficile remains the most important cause of healthcare-associated diarrhea and has become the most commonly identified cause of healthcare-associated infection in adults in the United States. Moreover, C. difficile has established itself as an important community pathogen. Although the prevalence of the epidemic and virulent ribotype 027 strain has declined markedly along with overall CDI rates in parts of Europe, it remains one of the most commonly identified strains in the United States where it causes a sizable minority of CDIs, especially healthcare-associated CDIs. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, infection prevention, and environmental management.

Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA)

2010 ◽  
Vol 31 (05) ◽  
pp. 431-455 ◽  
Author(s):  
Stuart H. Cohen ◽  
Dale N. Gerding ◽  
Stuart Johnson ◽  
Ciaran P. Kelly ◽  
Vivian G. Loo ◽  
...  
Keyword(s):  
Environmental Management ◽  
Clinical Practice ◽  
Clostridium Difficile ◽  
Infection Control ◽  
Practice Guidelines ◽  
Virulent Strain ◽  
Severe Disease ◽  
Position Paper ◽  
Healthcare Associated ◽  
Healthcare Epidemiology

Since publication of the Society for Healthcare Epidemiology of America position paper onClostridium difficileinfection in 1995, significant changes have occurred in the epidemiology and treatment of this infection.C. difficileremains the most important cause of healthcare-associated diarrhea and is increasingly important as a community pathogen. A more virulent strain ofC. difficilehas been identified and has been responsible for more-severe cases of disease worldwide. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published. Despite the increasing quantity of data available, areas of controversy still exist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management.

scholarly journals FECAL MICROBIOTES TRANSPLANTATION TECHNOLOGIES: MEDICAL, BIOTECHNOLOGICAL AND REGULATORY ASPECTS

2021 ◽  
Vol 14 (1) ◽  
pp. 46-56
Author(s):  
M. M. Bakalchuk ◽  
Keyword(s):  
Clinical Practice ◽  
Gastrointestinal Tract ◽  
Clostridium Difficile ◽  
Fecal Microbiota Transplantation ◽  
Treatment Method ◽  
Fecal Microbiota ◽  
Medical Community ◽  
Therapeutic Application ◽  
Regulatory Aspects ◽  
Recurrent Clostridium Difficile Infection

Fecal microbiota transplantation (FMT) is a treatment method based on donor's fecal solution injection into the patient's gastrointestinal tract. FMT is effectively used in the treatment of recurrent Clostridium difficile infection. There is also growing interest in the therapeutic application of the method to treat metabolic, autoimmune and other disorders that was not previously associated with intestinal microbiota. Despite the promising results of FMT use, the organizational and legal matters and that of the safety FMT application have not yet been resolved in the European and Ukrainian medical community. The purpose of this review was to summarize information on the FMT application and the regulatory aspects of its use. The analysis of the practical instructions provisions of for FMT applying in clinical practice was carried out, and the bioethical problems associated with the FMT use were investigated.

scholarly journals Review of updated clinical practice guidelines of the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) for Clostridium difficile infection in adults and children (2017)

2018 ◽  
Vol 20 (2) ◽  
pp. 76-124
Author(s):  
Roman S. Kozlov ◽  
Yu.A. Shelygin ◽  
Alexander V. Veselov ◽  
Andrey V. Dekhnich ◽  
N.A. Zubareva ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Clostridium Difficile ◽  
Infectious Diseases ◽  
Clostridium Difficile Infection ◽  
Practice Guidelines ◽  
Clinical Practice Guideline ◽  
Practice Guideline ◽  
Adults And Children ◽  
Healthcare Epidemiology ◽  
Source Of Information

An update on 2010 clinical practice guideline on Clostridium difficile infection (CDI) by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) was published in March 2018. This new version of guideline not only includes significant changes in the management of this infection and reflects the evolving controversy over best methods for diagnosis and threatment of CDI but has also incorporated recommendations for children. This document currently is the most complete and up to date source of information on CDI. In the present article we reviewed this new IDSA/SHEA guideline and compared it with existing European and Russian guidelines.

scholarly journals I’ve got Toothache, I need Antibiotics: a UK Perspective on Rational Antibiotic Prescribing by Dentists

2018 ◽  
Vol 29 (4) ◽  
pp. 395-399
Author(s):  
Wendy Thompson ◽  
Leonardo Essado Rios ◽  
Zbys Fedorowicz ◽  
Yvonne Dailey ◽  
Gail Douglas
Keyword(s):  
Antibiotic Resistance ◽  
Severe Sepsis ◽  
Clinical Practice ◽  
Clostridium Difficile ◽  
Antibiotic Prescription ◽  
Good Clinical Practice ◽  
Antibiotic Prescribing ◽  
Evidence Based ◽  
Audit Tool ◽  
Dental Conditions

Abstract Antibiotics do not cure toothache. This headline message of the United Kingdom’s (UK) Dental Antimicrobial Stewardship (AMS) toolkit’s posters and leaflets is aimed at patients; clinicians are expected to know this already. Evidence based clinical guidelines exist to set clear standards for good clinical practice yet there are barriers to compliance. The national AMS audit tool is designed for clinicians to review their management of acute dental conditions, including but not limited to the prescription of antibiotics. In this article we aim to help dental teams protect their patients and themselves from adverse events related to antibiotic prescription. It explores the emergent problem of Clostridium difficile, antibiotic resistance and severe sepsis, and considers some of the barriers, which clinicians have suggested, contribute to the unjustified prescription of antibiotics. Dentists must weigh the risks against the benefits before prescribing any antibiotic.

Impact of Revised Infectious Diseases Society of America and Society for Healthcare Epidemiology of America Clinical Practice Guidelines on the Treatment of Clostridium difficile Infections in the United States

2020 ◽  
Author(s):  
Cornelius J Clancy ◽  
Deanna Buehrle ◽  
Michelle Vu ◽  
Marilyn M Wagener ◽  
M Hong Nguyen
Keyword(s):  
United States ◽  
Clinical Practice ◽  
Clostridium Difficile ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Day Treatment ◽  
The United States ◽  
Prescription Data ◽  
Oral Vancomycin ◽  
Oral Metronidazole

Abstract Background Our objective was to determine if oral vancomycin, fidaxomicin, and oral metronidazole use in the United States changed after publication of revised clinical practice guidelines for Clostridium difficile infection (CDI) in February 2018. Methods We obtained US antibiotic prescription data (IQVIA) from 2006–August 2019 and used guideline-recommended dosing regimens to estimate monthly numbers of 10-day treatment courses of vancomycin, fidaxomicin and metronidazole. Interrupted time-series analyses were performed, adjusted by month. We compared linear trends for monthly numbers of treatment courses in different time periods. Results Cumulative treatment courses of oral vancomycin and fidaxomicin increased by 54% (n = 226 166) and 48% (n = 18 518), respectively, in 18 months following guidelines compared with 18 months before; those of oral metronidazole decreased by 3% (n = 238 372). Monthly vancomycin and fidaxomicin use significantly increased throughout the period following revised guidelines (P < .0001 and P = .0002, respectively), whereas that of metronidazole decreased significantly (P < .0001). Monthly vancomycin use increased and metronidazole use decreased to a significantly greater extent after publication of revised guidelines than after publication of clinical trials establishing superiority of vancomycin over metronidazole (P < .0001). Conclusions Revised practice guidelines have had a significant impact on CDI treatment in the US. Clinical trial data used for the revised guidelines were available since 2007–2014 and 2011–2012 for oral vancomycin and fidaxomicin, respectively. Guidelines or guidance documents for treating CDI and other infections should be updated in more timely fashion.

scholarly journals Ultrasensitive Detection of Clostridium difficile Toxins Reveals Suboptimal Accuracy of Toxin Gene Cycle Thresholds for Toxin Predictions

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Johanna Sandlund ◽  
Mark H. Wilcox
Keyword(s):  
Clinical Practice ◽  
Nucleic Acid ◽  
Clostridium Difficile ◽  
Predictive Accuracy ◽  
High Sensitivity ◽  
Nucleic Acid Amplification ◽  
Toxin Gene ◽  
Ultrasensitive Detection ◽  
Surrogate Markers ◽  
Recent Interest

ABSTRACT The use of nucleic acid amplification tests (NAATs) for the diagnosis of Clostridium (Clostridioides) difficile infection (CDI) leads to overdiagnosis. To improve the clinical specificity of NAATs, there has been a recent interest in using toxin gene cycle thresholds (CTs) to predict the presence and absence of toxins. Although there is an association between CT values and fecal toxin concentrations, the predictive accuracy of the former is suboptimal for use in clinical practice. Ultrasensitive toxin immunoassays to quantify free toxins in stool offer a novel option for high-sensitivity fecal toxin detection rather than using surrogate markers for prediction.

Sign in / Sign up

Export Citation Format

Share Document