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How to: Clostridioides difficile infection in children

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European Society of Clinical Microbiology and Infectious Diseases: 2021 update on the treatment guidance document for Clostridioides difficile infection in adults

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Summary: The document provides guidance on the treatment of Clostridioides difficile infection with a focus on the best treatment methods and factors influencing treatment strategies.

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Cost-effectiveness of bezlotoxumab and fidaxomicin for initial Clostridioides difficile infection

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Summary: The study evaluated the cost-effectiveness of fidaxomicin and bezlotoxumab in treating initial CDI compared to standard therapy with oral vancomycin. Extended-pulsed fidaxomicin was found to be the most cost-effective treatment, while standard fidaxomicin was more effective than vancomycin and the bezlotoxumab-containing regimen required higher costs.

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Summary: This study found that Clostridium difficile infection is a rare but impactful complication of pediatric appendicitis, associated with greater disease severity. Proper antibiotic stewardship could minimize the risk of C. difficile in pediatric appendicitis.

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Summary: Recent advancements in research on CDI in children have led to better understandings of C. difficile acquisition in healthcare settings, risk factors for recurrent and community-associated CDI, diagnostic test performance in children, and a more rigorous evidence base for CDI treatment in children.

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Epidemiologic and Clinical Characteristics of Clostridioides difficile Infections in Hospitalized and Outpatient Pediatric Oncology and Hematopoietic Stem Cell Transplant Patients

Ruba Barbar et al.

Summary: This retrospective cohort study aimed to describe the epidemiology and clinical features of Clostridioides difficile infection (CDI) in pediatric oncology and hematopoietic stem cell transplant patients. The results showed that most CDI cases were incident and associated with leukemia/lymphoma, and chemotherapy delay was common. Exposure to H2-antagonists was identified as an independent risk factor for CDI recurrence.

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Summary: While rates of CDI infection are rising among children in the US, studies on treatment are lacking. Guidelines have historically relied on limited data and adult trials. Recent RCT suggests fidaxomicin is as effective as vancomycin for pediatric CDI treatment, making it a more appropriate option.

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