Clostridium difficile-associated Diarrhea: Brief Review and Update of Medical Management

近二十年的期間，困難梭狀芽孢桿菌相關腹瀉在流行病學與治療方面都有顯著的改變。在醫療相關腹瀉的個案中，困難梭狀芽孢桿菌扮演著重要的致病因，且社區型感染有增加的趨勢。現今全世界廣泛探討著更具毒力之困難梭狀芽孢桿菌種BI-NAP1-027和非BI-NAP1-027所引發病情，而這幾乎與所有類別的抗生素使用有關，特別菌種BI-NAP1-027所引起的感染更是嚴重。近幾年的文獻指出，硝基甲嘧唑乙醇（metronidazole）在治療困難梭狀芽孢桿菌相關腹瀉成效上相較於萬古黴素（vancomycin）有減弱的趨勢，是否因此無法使用該藥與尋求較佳治療藥物，在文獻上仍是一個具爭議的議題。因此我們藉由文獻回顧，探討該疾病在藥物治療上的進展，值得注意的是新核准使用的藥物Fidaxomicin，除了對該疾病有顯著的療效，更用以選擇在治療復發性的感染。

關鍵字

無資料

並列摘要

In the past decade, the epidemiology and treatment of Clostridium difficile-associated diarrhea (CDAD) have significantly changed. C. difficile remains the most important cause of healthcare-associated diarrhea and is increasingly important as a community pathogen. The strains of C. difficile with hypervirulent BI-NAP1-027 and non- BI-NAP1-027 have been reported for after the use of nearly all systemic antibacterial agents worldwide, and strain with BI-NAP1-027 has been responsible for more severe cases of disease. The decreased effectiveness of metronidazole relative to vancomycin in the treatment of CDAD has been demonstrated. Areas of controversy still exist about the best treatment plans, despite the increasing quantity of available data in the literature. Here we review progress in antimicrobial therapy and review currently available non-antimicrobial strategies for CDAD management. The new approval agent, fidaxomicin, has the major benefit to treat CDAD, and has become the therapy of choice for recurrent CDAD.

並列關鍵字

Clostridium difficile ； Diarrhea ； Management ； Fidaxomicin

國際替代計量

Clostridium difficile-associated Diarrhea: Brief Review and Update of Medical Management

全文下載

主題瀏覽