Clostridium difficile infection in the elderly: an update on management

Tomefa E Asempa, David P Nicolau Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA Abstract: The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care–associated diarrhea, and is as...

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Autores principales:	Asempa TE, Nicolau DP
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2017
Materias:	Clostridium difficile elderly risk factors Geriatrics RC952-954.6
Acceso en línea:	https://doaj.org/article/bcca0094cc534ad381968a0e05db9733
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spelling	oai:doaj.org-article:bcca0094cc534ad381968a0e05db97332021-12-02T05:18:37ZClostridium difficile infection in the elderly: an update on management1178-1998https://doaj.org/article/bcca0094cc534ad381968a0e05db97332017-10-01T00:00:00Zhttps://www.dovepress.com/clostridium-difficile-infection-in-the-elderly-an-update-on-management-peer-reviewed-article-CIAhttps://doaj.org/toc/1178-1998Tomefa E Asempa, David P Nicolau Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA Abstract: The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care–associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care–associated CDIs occur in patients 65 years or older. Additionally, the elderly are at higher risk for recurrent CDI. Existing therapeutic options include metronidazole, oral vancomycin, and fidaxomicin. Choice of agent depends on disease severity, history of recurrence, and, increasingly, the drug cost. Bezlotoxumab, a recently approved monoclonal antibody targeting C. difficile toxin B, offers an exciting advancement into immunologic therapies. Similarly, fecal microbiota transplantation is gaining popularity as an effective option mainly for recurrent CDI. The challenge of decreasing CDI burden in the elderly involves adopting preventative strategies, optimizing initial treatment, and decreasing the risk of recurrence. Expanded strategies are certainly needed to improve outcomes in this high-risk population. This review considers available data from prospective and retrospective studies as well as case reports to illustrate the merits and gaps in care related to the management of CDI in the elderly. Keywords: Clostridium difficile, recurrence, risk factors, elderly, aging, treatment, bezlotoxumab, fecal microbiota transplantAsempa TENicolau DPDove Medical PressarticleClostridium difficileelderlyrisk factorsGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 12, Pp 1799-1809 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Clostridium difficile elderly risk factors Geriatrics RC952-954.6
spellingShingle	Clostridium difficile elderly risk factors Geriatrics RC952-954.6 Asempa TE Nicolau DP Clostridium difficile infection in the elderly: an update on management
description	Tomefa E Asempa, David P Nicolau Center for Anti-Infective Research and Development, Hartford Hospital, Hartford, CT, USA Abstract: The burden of Clostridium difficile infection (CDI) is profound and growing. CDI now represents a common cause of health care–associated diarrhea, and is associated with significant morbidity, mortality, and health care costs. CDI disproportionally affects the elderly, possibly explained by the following risk factors: age-related impairment of the immune system, increasing antibiotic utilization, and frequent health care exposure. In the USA, recent epidemiological studies estimate that two out of every three health care–associated CDIs occur in patients 65 years or older. Additionally, the elderly are at higher risk for recurrent CDI. Existing therapeutic options include metronidazole, oral vancomycin, and fidaxomicin. Choice of agent depends on disease severity, history of recurrence, and, increasingly, the drug cost. Bezlotoxumab, a recently approved monoclonal antibody targeting C. difficile toxin B, offers an exciting advancement into immunologic therapies. Similarly, fecal microbiota transplantation is gaining popularity as an effective option mainly for recurrent CDI. The challenge of decreasing CDI burden in the elderly involves adopting preventative strategies, optimizing initial treatment, and decreasing the risk of recurrence. Expanded strategies are certainly needed to improve outcomes in this high-risk population. This review considers available data from prospective and retrospective studies as well as case reports to illustrate the merits and gaps in care related to the management of CDI in the elderly. Keywords: Clostridium difficile, recurrence, risk factors, elderly, aging, treatment, bezlotoxumab, fecal microbiota transplant
format	article
author	Asempa TE Nicolau DP
author_facet	Asempa TE Nicolau DP
author_sort	Asempa TE
title	Clostridium difficile infection in the elderly: an update on management
title_short	Clostridium difficile infection in the elderly: an update on management
title_full	Clostridium difficile infection in the elderly: an update on management
title_fullStr	Clostridium difficile infection in the elderly: an update on management
title_full_unstemmed	Clostridium difficile infection in the elderly: an update on management
title_sort	clostridium difficile infection in the elderly: an update on management
publisher	Dove Medical Press
publishDate	2017
url	https://doaj.org/article/bcca0094cc534ad381968a0e05db9733
work_keys_str_mv	AT asempate clostridiumdifficileinfectionintheelderlyanupdateonmanagement AT nicolaudp clostridiumdifficileinfectionintheelderlyanupdateonmanagement
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Clostridium difficile infection in the elderly: an update on management

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