Journal
JOURNAL OF THE PEDIATRIC INFECTIOUS DISEASES SOCIETY
Volume 10, Issue -, Pages S52-S57Publisher
OXFORD UNIV PRESS
DOI: 10.1093/jpids/piab059
Keywords
children; Clostridium difficile; diarrhea; pediatric
Categories
Funding
- Pfizer
- Merck
- Azurity
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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.
While rates of Clostridioides difficile infection (CDI) are increasing among children in the United States, studies assessing CDI treatment in children are severely lacking. Thus, treatment guidelines have historically relied on evidence from limited observational data in children and randomized controlled trials (RCTs) conducted in adults to form recommendations. Currently, the Infectious Diseases Society of America (IDSA) and the Society for Healthcare Epidemiology of America (SHEA) recommend metronidazole and/or vancomycin for pediatric CDI depending on disease severity. Recently however, the first and only RCT of CDI treatment in children demonstrated fidaxomicin to be non-inferior to vancomycin, proving its safety and efficacy in this population. Additionally, observational data published since the IDSA/SHEA guidelines were released suggest metronidazole has lower rates of clinical improvement when compared to vancomycin in hospitalized children with non-severe CDI. Given these recent publications, fidaxomicin and vancomycin, instead of metronidazole, appear to be more appropriate, evidence-based options for the treatment of CDI in children.
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