New Guidelines Available for Diagnosis, Prevention, and Treatment of CDI

If clinicians have a strong pretest suspicion that a patient has a Clostridium difficile infection (CDI), empiric therapy for CDI should be considered regardless of the laboratory result, as the negative predictive values for CDI are insufficiently high to exclude disease among these patients, states new practice guidelines for the diagnosis, treatment, and prevention of CDI published in the April 2013 issue of the American Journal of Gastroenterology. The guidelines, which are intended to supplement existing guidelines from the Infectious Disease Society of America, the Society of Hospital Epidemiology of America, and the European Society of Clinical Microbiology and Infectious Diseases, provide recommendations for the diagnosis and management of patients with CDI, as well as for the prevention and control of outbreaks at healthcare facilities. According to the guidelines, new molecular diagnostic stool tests will likely replace current enzyme immunoassay tests. Although therapy with metronidazole remains the choice for mild-to-moderate disease, it may not be adequate for patients with severe or complicated disease.