Journal Article


Mark H Wilcox
Christopher Rooney
Karen Burns
Melissa Brady
Mairead Skally
Fidelma Fitzpatrick



clostridium difficile clinical trials microbiology management treatment european infectious diseases phase iii

European Practice for CDI Treatment. (2018)

Abstract Clostridium difficile infection (CDI) remains a significant cause of morbidity and mortality worldwide. Historically, two antibiotics (metronidazole and vancomycin) and a recent third (fidaxomicin) have been used routinely for CDI treatment; convincing data are now available showing that metronidazole is the least efficacious agent. The European Society of Clinical Microbiology and Infectious Diseases CDI treatment guidelines outline the treatment options for a variety of CDI clinical scenarios, including use of the more traditional anti-CDI therapies (e.g., metronidazole, vancomycin), the role of newer anti-CDI agents (e.g., fidaxomicin), indications for surgical intervention and for non-antimicrobial management (e.g., faecal microbiota transplantation, FMT). A 2017 survey of 20 European countries found that while the majority (n = 14) have national CDI guidelines that provide a variety of recommendations for CDI treatment, only five have audited guideline implementation. A variety of restrictions are in place in 13 (65%) countries prior to use of new anti-CDI treatments, including committee/infection specialist approval or economic review/restrictions. Novel anti-CDI agents are being evaluated in Phase III trials; it is not yet clear what will be the roles of these agents. Prophylaxis is an optimum approach to reduce the impact of CDI especially in high-risk populations; monoclonal antibodies, antibiotic blocking approaches and multiple vaccines are currently in advanced clinical trials. The treatment of recurrent CDI is particularly troublesome, and several different live bio therapeutics are being developed, in addition to FMT.
Collections Ireland -> Royal College of Surgeons in Ireland -> PubMed

Full list of authors on original publication

Mark H Wilcox, Christopher Rooney, Karen Burns, Melissa Brady, Mairead Skally, Fidelma Fitzpatrick

Experts in our system

Karen Burns
Royal College of Surgeons in Ireland
Total Publications: 10
M. Skally
Royal College of Surgeons in Ireland
Total Publications: 7
F Fitzpatrick
Royal College of Surgeons in Ireland
Total Publications: 25