| Theme |
Infectious diseases of the intestine |
| Title |
Diagnosis and treatment of Clostridioides (Clostridium) difficile infection |
| Author |
Katsuyoshi Matsuoka |
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Toho University Sakura Medical Center |
| [ Summary ] |
Clostridioides difficile (C. difficile) colonizes the colon when the gut microbiota is disturbed by antibiotics. It causes Clostridioides difficile infection （CDI） through the production of two exotoxins (toxin A and toxin B). CDI is diagnosed with a fecal C. difficile toxin test. Metronidazole and oral vancomycin are used for treatment. Fidaxomycin, a novel antimicrobial agent, is positioned as a treatment option in severe cases, recurrent cases, and refractory cases. CDI recurs frequently. Bezrotocsumab is a monoclonal antibody against C. difficile toxin B. It is expected to be effective in patients with repeated relapses or those with a high risk of recurrence. Fecal microbial transplantation has attracted attention as a treatment option in patients with multiple recurrences. |