Disclosures: Johnson reports serving as an advisory board member for Acurx Pharmaceuticals, Bio-K+, Cutis Pharma and Summit Therapeutics. Johnson also reports receiving remuneration from Ferring Pharmaceutical for developing an education monograph for transition of care for C. difficile and from Pfizer as a member of its data monitoring committee. He also served on the steering committee for Synthetic Biologics. Please see the guidelines for all other authors’ relevant financial disclosures.
June 24, 2021
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IDSA, SHEA update guidance for managing patients with C. difficile

Disclosures: Johnson reports serving as an advisory board member for Acurx Pharmaceuticals, Bio-K+, Cutis Pharma and Summit Therapeutics. Johnson also reports receiving remuneration from Ferring Pharmaceutical for developing an education monograph for transition of care for C. difficile and from Pfizer as a member of its data monitoring committee. He also served on the steering committee for Synthetic Biologics. Please see the guidelines for all other authors’ relevant financial disclosures.
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The Infectious Diseases Society of America and The Society for Healthcare Epidemiology of America, or SHEA, have released new guidelines for the management of Clostridioides difficile.

The guidance, which was published in Clinical Infectious Diseases, offers recommendations for providers caring for adults with C. difficile infection (CDI), including infectious diseases specialists, gastroenterologists, hospitalists and pharmacists.

C. diff infographic
Source: Johnson S, et al. Clin Infect Dis. 2021;doi:10.1093/cid/ciab549.

“The panel’s recommendations for the management of CDI are based upon evidence derived from topic-specific systematic literature reviews,” Stuart Johnson, MD, infectious disease clinician and researcher at the Edward Hines Jr. Veterans Administration Hospital, and colleagues wrote.

The new guidance for CDI management in adults is as follows:

  • For patients with an initial C. difficile episode, fidaxomicin is recommended rather than a standard course of vancomycin.
  • For patients with recurrent C. difficile episodes, a standard or extended-pulsed regimen of fidaxomicin should be used rather than a standard course of vancomycin.
  • For patients with a recurrent C. difficile episode within the past 6 months, bezlotoxumab and standard-of-care antibiotics should be used rather than standard-of-care antibiotics alone.

“Head-to-head trials of differing anti-CDI recurrence strategies using narrow-spectrum antibiotics that target C. difficile, restoration of the microbiome using biotherapeutics or [fecal microbiota transplantation], or augmentation of the host immune response with agents such as bezlotoxumab given alone or in combination (eg, in combination with fidaxomicin) are needed,” the authors wrote.