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Severe Clostridium difficile infection 

Severe Clostridium difficile infection
Chapter:
Severe Clostridium difficile infection
Author(s):

Jasmin Islam

DOI:
10.1093/med/9780199665754.003.0020
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date: 27 February 2020

The dramatic decline in C. difficile (CDI) rates seen in the UK since 2006 and the waning of ribotype 027 should not be a reason for complacency about this disease. With the recognition of novel virulent strains of other ribotypes and an aging population it is clear that CDI diarrhoea will remain a threat to elderly patients, particularly those in hospital. This case illustrates the importance of early recognition, diagnosis, and assessment of severe CDI to ensure both optimal infection control and management. The advent of fidaxomicin represents a significant advance but important questions remain around selection of patients to receive this treatment. Faecal therapy is now supported by randomized controlled trial evidence but more extensive clinical evaluation of this approach, in particular the role of synthetic stool, is needed before it is likely to be widely adopted.

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