Clostridium difficile Infections: Diagnosis, Treatment, and Prevention
Overview: Results for Treatment of CDI with Standard Antibiotics
For standard antibiotic treatment, no antimicrobial is clearly superior for the initial cure of CDI. There is moderate strength evidence that vancomycin has similar initial cure rates as metronidazole as well as fidaxomicin. Moderate strength evidence also suggests that recurrence is reduced by 10 percent when patients were treated with fidaxomicin when compared with vancomycin. This reduction is most likely due to infections with a non-NAP1 (non-North American Pulsed Field type 1) strain of C. difficile. There is low strength evidence that patients treated with vancomycin for a non-NAP1 strain infection were about 3 times as likely to have a recurrence than patients treated with fidaxomicin, but patients with the NAP1 strain had recurrence rates that did not differ significantly by treatment.
- 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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