Guidelines for diagnosis, treatment, and prevention of clostridium difficile infections

Christina M. Surawicz, Lawrence J. Brandt, David G. Binion, Ashwin N. Ananthakrishnan, Scott R. Curry, Peter H. Gilligan, Lynne V. McFarland, Mark Mellow, Brian S. Zuckerbraun

Research output: Contribution to journalReview article

969 Scopus citations

Abstract

Clostridium difficile infection (CDI) is a leading cause of hospital-associated gastrointestinal illness and places a high burden on our health-care system. Patients with CDI typically have extended lengths-of-stay in hospitals, and CDI is a frequent cause of large hospital outbreaks of disease. This guideline provides recommendations for the diagnosis and management of patients with CDI as well as for the prevention and control of outbreaks while supplementing previously published guidelines. New molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. We suggest treatment of patients be stratified depending on whether they have mild-to-moderate, severe, or complicated disease. Therapy with metronidazole remains the choice for mild-to-moderate disease but may not be adequate for patients with severe or complicated disease. We propose a classification of disease severity to guide therapy that is useful for clinicians. We review current treatment options for patients with recurrent CDI and recommendations for the control and prevention of outbreaks of CDI.

Original languageEnglish (US)
Pages (from-to)478-498
Number of pages21
JournalAmerican Journal of Gastroenterology
Volume108
Issue number4
DOIs
StatePublished - Apr 1 2013

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ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Surawicz, C. M., Brandt, L. J., Binion, D. G., Ananthakrishnan, A. N., Curry, S. R., Gilligan, P. H., McFarland, L. V., Mellow, M., & Zuckerbraun, B. S. (2013). Guidelines for diagnosis, treatment, and prevention of clostridium difficile infections. American Journal of Gastroenterology, 108(4), 478-498. https://doi.org/10.1038/ajg.2013.4