The evolution of clostridium difficile infection in cancer patients: Epidemiology, pathophysiology, and guidelines for prevention and management

Areej Khan, Shahzad Raza, Syeda A. Batul, Monis Khan, Tulay Aksoy, Mahadi A. Baig, Barbara J. Berger

Research output: Contribution to journalReview article

23 Scopus citations


Clostridium difficile infection (CDI) has emerged as a significant challenge to the healthcare system. The availability of anti-cancer chemotherapeutic regimens has contemporaneously resulted in a larger population of patients who are susceptible to CDI. The outbreak of a novel, hypervirulent, resistant strain, NAP-1/027 as well as resistance to antibiotic therapy have further contributed to an increase in prevalence as well as in disease severity. Recent data show high fatality rates in cancer patients with CDI. In this review, we have discussed the incidence, epidemiology, pathophysiology, clinical signs and symptoms and therapeutic guidelines for patients who are on chemotherapy and present with CDI and highlighted clinical reports documenting severe CDI associated with chemotherapeutic agents such as methotrexate, 5FU, cisplatin, carboplatin, paclitaxel, vinorelbine and cyclophosphamide. The review article also has the discussion of patents pertaining to infections caused by Clostridium difficile in cancer patients. We underscore the urgent need for early recognition and diagnosis of CDI in cancer patients and for the design and implementation of randomized clinical trials of new treatment modalities in the management of chemotherapy- associated CDI.

Original languageEnglish (US)
Pages (from-to)157-170
Number of pages14
JournalRecent Patents on Anti-Infective Drug Discovery
Issue number2
Publication statusPublished - Jul 23 2012



  • Anti-neoplastic chemotherapy
  • Clostridium difficile infection
  • Hypervirulent strain NAP-1/027
  • Metronidazole
  • Vancomycin

ASJC Scopus subject areas

  • Drug Discovery
  • Infectious Diseases
  • Pharmacology (medical)

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