IDSA Updates Clostridioides difficile Guidelines

The Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America have updated their guidelines on the management and treatment of Clostridioides difficile infection (CDI) in adults.

The groups utilized the Grading Recommendations Assessment, Development and Evaluation (GRADE) procedure to update the 2017 clinical practice guidelines.

Among the new recommendations:

• Fidaxomicin is recommended over the standard course of vancomycin for patients’ first CDI episode
• Fidaxomicin (standard or extended-pulsed regimen) is recommended over the standard course of vancomycin for recurrent CDI episodes
• Bezlotoxumab is recommended as a co-intervention with standard-of-care antibiotics over just standard-of-care antibiotics alone for recurrent CDI episodes within the last 6 months

“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 (e.g., in combination with fidaxomicin) are needed,” the panel concluded.

—Leigh Precopio

Reference:

Johnson S, Lavergne V, Skinner AM, et al. Clinical practice guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 focused update guidelines on management of Clostridioides difficile infection in adults. IDSA. Published June 24, 2021. https://doi.org/10.1093/cid/ciab549