Clostridium difficile Infections: Diagnosis, Treatment, and Prevention
Overview: Results for Nonstandard Interventions to Treat CDI or Reduce the Risk of Recurrence
Numerous potential new forms of treatment are being examined in placebo controlled RCTs, case series, and case reports. There is low strength evidence that adding probiotics containing Saccharomyces cerevisiae or Saccharomyces boulardii to antibiotics for primary treatment may increase the risk for fungemia-related complications in critically ill patients and adds no known benefit. Probiotics, prebiotics, and toxin-neutralizing antibodies alone do not reduce primary hospital CDI incidence rates. C. difficile immune whey (CDIW) is well-tolerated and the overall response rate was similar to metronidazole. Fecal flora reconstitution via fecal transplantation prevents recurrent infections for up to 1 year. CDI recurrence rates were reduced three-fold when an oligofructose prebiotic or toxin-neutralizing antibodies were added to standard antibiotics.
Keywords: antibodies | C. difficile immune whey | fecal transplantation | nonstandard interventions | prebiotics | probiotics | recurrence | overview
- Butler M, Bliss D, Drekonja D, Filice G, Rector T, MacDonald R, Wilt T. Effectiveness of Early Diagnosis, Prevention, and Treatment of Clostridium difficile Infection. Comparative Effectiveness Review No. 31 (Prepared by the Minnesota Evidence-based Practice Center under Contract No. 290-02-0009.) AHRQ Publication No. 11(12)-EHC051-EF. Rockville, MD. Agency for Healthcare Research and Quality. December 2011. Available at: http://www.effectivehealthcare.ahrq.gov/index.cfm/search-for-guides-reviews-and-reports/?pageaction=displayproduct&productID=772.
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