Management of Clostridioides difficile infection: an Italian Delphi consensus.

Autor:	Bassetti M; Infectious Diseases Unit, IRCCS Ospedale Policlinico San Martino, 16132 Genoa, Italy., Cascio A; Department PROMISE-Infectious and Tropical Diseases Unit, AOU Policlinico 'P. Giaccone', University of Palermo, 90127 Palermo, Italy., De Rosa FG; Department of Medical Sciences, University of Turin, 10126 Turin, Italy., Meschiari M; Department of Infectious Diseases, Azienda Ospedaliero-Universitaria di Modena, Policlinico di Modena, University of Modena and Reggio Emilia, 41125 Modena, Italy., Parrella R; Unit of Respiratory Infectious Diseases, Cotugno Hospital, Azienda Ospedaliera dei Colli, 80131 Naples, Italy., Petrosillo N; Infection Prevention and Control Service, Fondazione Policlinico Universitario Campus Bio-Medico, 00127 Rome, Italy., Armuzzi A; IBD Unit, IRCCS Humanitas Research Hospital, Via A. Manzoni 56, Rozzano, 20089 Milan, Italy.; Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20072 Milan, Italy., Caprioli F; Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20133 Milan, Italy.; Gastroenterology and Endoscopy Unit, Fondazione IRCCS Cà Granda, Ospedale Maggiore Policlinico di Milano, 20122 Milan, Italy., Dentali F; Division of Internal Medicine, Medical Center, Ospedale di Circolo & Fondazione Macchi, ASST Sette Laghi, 21100 Varese, Italy.; Department of Medicine and Surgery, Insubria University, 21100 Varese, Italy., Pani M; Hospital Pharmacy, Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy., Pilotto A; Department of Interdisciplinary Medicine, 'Aldo Moro' University of Bari, 70121 Bari, Italy.; Geriatrics Unit, Department of Geriatric Care, Neurology and Rehabilitation, Galliera Hospitals, 16128 Genova, Italy., Restelli U; LIUC-Carlo Cattaneo University, 21053 Castellanza, VA, Italy., Sanguinetti M; Department of Laboratory and Infectious Sciences, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy.
Jazyk:	angličtina
Zdroj:	The Journal of antimicrobial chemotherapy [J Antimicrob Chemother] 2024 Sep 03; Vol. 79 (9), pp. 2103-2118.
DOI:	10.1093/jac/dkae179
Abstrakt:	Background: Clostridioides difficile infection (CDI), a leading cause of nosocomial deaths, is a microbiota-mediated disease. As such, the use of broader spectrum antibiotics, such as vancomycin and metronidazole, can prime the gastrointestinal tract to become more prone to CDI recurrences. Fidaxomicin, a narrow-spectrum antibiotic, has been demonstrated to be superior in preventing recurrence and in preserving the intestinal microbiota; however, widespread employment worldwide has been hindered due to high acquisition costs. Objectives: To integrate the currently available guidelines on the management of CDI and to shed light on the timeliest employment of fidaxomicin. Methods: An expert panel was gathered to obtain consensus using Delphi methodology on a series of statements regarding the management of CDI and on appropriate antibiotic use. Results: Consensus was reached on 21 of the 25 statements addressing the management of CDI. Conclusions: Delphi methodology was used to achieve consensus on the management of CDI, on the identification of patients at risk of recurrences or severe infection, and on the most appropriate use of fidaxomicin, with the final aim of fostering clinical practice application of treatment algorithms proposed by previous guidelines, in absolute synergy. It could be an important tool to promote more appropriate and cost-effective CDI treatments in European settings with limited resources, like Italy. (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu