Matching articles for "Clostridium difficile"
Live Fecal Microbiota Oral Capsules (Vowst) for Prevention of CDI Recurrence
The Medical Letter on Drugs and Therapeutics • May 29, 2023; (Issue 1677)
The FDA has approved Vowst (Seres Therapeutics/Nestle HealthScience), an oral capsule containing live
fecal microbiota spores, for prevention of additional
recurrences of Clostridioides difficile infection...
The FDA has approved Vowst (Seres Therapeutics/Nestle HealthScience), an oral capsule containing live
fecal microbiota spores, for prevention of additional
recurrences of Clostridioides difficile infection (CDI)
in adults. Vowst is the first orally administered
microbiota-based treatment to be approved for
this indication. A rectally-administered live fecal
microbiota-based suspension (Rebyota) was
approved in 2022 for the same indication. Neither
product is approved for acute treatment of CDI.
Live Fecal Microbiota (Rebyota) for Prevention of CDI Recurrence
The Medical Letter on Drugs and Therapeutics • March 6, 2023; (Issue 1671)
The FDA has approved Rebyota (Ferring), a rectally-administered,
live fecal microbiota suspension, for
prevention of additional recurrences of Clostridioides
difficile infection (CDI) following antibiotic...
The FDA has approved Rebyota (Ferring), a rectally-administered,
live fecal microbiota suspension, for
prevention of additional recurrences of Clostridioides
difficile infection (CDI) following antibiotic treatment
for a recurrent episode of CDI in adults. Rebyota is
the first microbiome-based treatment to be approved
for this indication. It is not approved for initial
treatment of CDI. Fecal microbiota transplantation
(FMT) has been used in patients with multiple
CDI recurrences.
Drugs for Sexually Transmitted Infections
The Medical Letter on Drugs and Therapeutics • June 27, 2022; (Issue 1653)
This article includes recommendations for management
of most sexually transmitted infections (STIs)
other than HIV and viral hepatitis. Some of the
indications and dosages recommended here have
not been...
This article includes recommendations for management
of most sexually transmitted infections (STIs)
other than HIV and viral hepatitis. Some of the
indications and dosages recommended here have
not been approved by the FDA (see Table 1).
Treatment of Clostridioides difficile Infection
The Medical Letter on Drugs and Therapeutics • September 6, 2021; (Issue 1632)
Clostridioides (formerly Clostridium) difficile infection
(CDI) is the most common infectious cause of
healthcare-associated diarrhea in adults. Guidelines
on management of CDI have recently been...
Clostridioides (formerly Clostridium) difficile infection
(CDI) is the most common infectious cause of
healthcare-associated diarrhea in adults. Guidelines
on management of CDI have recently been updated.
Antibacterial Drugs for Community-Acquired Pneumonia
The Medical Letter on Drugs and Therapeutics • January 25, 2021; (Issue 1616)
Treatment of community-acquired pneumonia (CAP)
is usually empiric, with selected antibiotic regimens
directed against some of the most common causative
pathogens. Recommended empiric regimens are
listed in...
Treatment of community-acquired pneumonia (CAP)
is usually empiric, with selected antibiotic regimens
directed against some of the most common causative
pathogens. Recommended empiric regimens are
listed in Table 2; recommended antibiotic dosages for
treatment of CAP are listed in Tables 3 and 4. Joint
guidelines for treatment of CAP by the American
Thoracic Society and the Infectious Diseases Society of
America (ATS/IDSA) were updated in 2019.
Rifamycin (Aemcolo) for Treatment of Travelers' Diarrhea
The Medical Letter on Drugs and Therapeutics • March 11, 2019; (Issue 1567)
The FDA has approved rifamycin (Aemcolo – Cosmo/
Aries), a minimally absorbed oral antibiotic, for
treatment of adults with travelers' diarrhea (TD)
caused by noninvasive strains of Escherichia coli....
The FDA has approved rifamycin (Aemcolo – Cosmo/
Aries), a minimally absorbed oral antibiotic, for
treatment of adults with travelers' diarrhea (TD)
caused by noninvasive strains of Escherichia coli. It
is not recommended for treatment of diarrhea that is
complicated by fever and/or bloody stools. Topical
and injectable formulations of rifamycin have been
used in Europe for other indications for many years.
Firvanq - Vancomycin Oral Solution
The Medical Letter on Drugs and Therapeutics • July 16, 2018; (Issue 1551)
The FDA has approved vancomycin oral solution
(Firvanq – Cutis Pharma) for treatment of Clostridium
difficile-associated diarrhea and enterocolitis caused
by Staphylococcus aureus, including...
The FDA has approved vancomycin oral solution
(Firvanq – Cutis Pharma) for treatment of Clostridium
difficile-associated diarrhea and enterocolitis caused
by Staphylococcus aureus, including methicillin-resistant
strains (MRSA).
Meropenem/Vaborbactam (Vabomere) for Complicated Urinary Tract Infection
The Medical Letter on Drugs and Therapeutics • June 18, 2018; (Issue 1549)
The FDA has approved a fixed-dose combination of
meropenem, a carbapenem antibiotic, and vaborbactam,
a new beta-lactamase inhibitor (Vabomere – Melinta),
for IV treatment of adults with complicated...
The FDA has approved a fixed-dose combination of
meropenem, a carbapenem antibiotic, and vaborbactam,
a new beta-lactamase inhibitor (Vabomere – Melinta),
for IV treatment of adults with complicated urinary
tract infections (UTIs) that are proven or strongly
suspected to be caused by Escherichia coli, Klebsiella
pneumoniae, or Enterobacter cloacae spp. complex.
Meropenem (Merrem, and generics) has been approved
for years for treatment of complicated skin and skin
structure infections, intra-abdominal infections, and
bacterial meningitis. Resistance to meropenem and
other carbapenems, mainly due to production of
carbapenemases and other extended-spectrum beta-lactamases
(ESBLs), has been increasing worldwide,
particularly among Enterobacteriaceae. Vabomere
is the first carbapenem/beta-lactamase inhibitor
combination to be marketed in the US.
Secnidazole (Solosec) for Bacterial Vaginosis
The Medical Letter on Drugs and Therapeutics • March 26, 2018; (Issue 1543)
The FDA has approved secnidazole oral granules
(Solosec – Symbiomix/Lupin) for single-dose treatment
of bacterial vaginosis (BV) in adult...
The FDA has approved secnidazole oral granules
(Solosec – Symbiomix/Lupin) for single-dose treatment
of bacterial vaginosis (BV) in adult women.
Safety of Long-Term PPI Use
The Medical Letter on Drugs and Therapeutics • August 14, 2017; (Issue 1527)
Proton pump inhibitors (PPIs), which are used for
treatment of gastroesophageal reflux disease (GERD)
and for prevention of upper gastrointestinal adverse
effects caused by NSAIDs and aspirin, are one...
Proton pump inhibitors (PPIs), which are used for
treatment of gastroesophageal reflux disease (GERD)
and for prevention of upper gastrointestinal adverse
effects caused by NSAIDs and aspirin, are one of
the most commonly prescribed classes of drugs in
the US. All PPIs are similarly effective and generally
well tolerated, but their long-term use has been
associated with a number of safety concerns.
Recommendations addressing these concerns have
recently been published.
Drugs for Helicobacter pylori Infection
The Medical Letter on Drugs and Therapeutics • July 17, 2017; (Issue 1525)
About 50% of the world’s population is infected with
Helicobacter pylori. These gastric bacteria can cause
chronic inflammation and have been associated with
development of gastritis, peptic ulcer disease,...
About 50% of the world’s population is infected with
Helicobacter pylori. These gastric bacteria can cause
chronic inflammation and have been associated with
development of gastritis, peptic ulcer disease, gastric
adenocarcinoma, and gastric mucosa-associated
lymphoid tissue (MALT) lymphoma. Eradication of H.
pylori can promote gastric healing, prevent recurrence
of duodenal and gastric ulcers, and reduce the
incidence of gastric cancer. Guidelines for treatment
of H. pylori infection were updated recently.
Bezlotoxumab (Zinplava) for Prevention of Recurrent Clostridium difficile Infection
The Medical Letter on Drugs and Therapeutics • March 27, 2017; (Issue 1517)
The FDA has approved the fully human monoclonal
antibody bezlotoxumab (Zinplava – Merck) for use
with antibacterial drug treatment to reduce recurrence
of Clostridium difficile infection (CDI) in adults...
The FDA has approved the fully human monoclonal
antibody bezlotoxumab (Zinplava – Merck) for use
with antibacterial drug treatment to reduce recurrence
of Clostridium difficile infection (CDI) in adults with
CDI at high risk for recurrence. It is the first drug to be
approved for this indication.
Drugs for Bacterial Infections
The Medical Letter on Drugs and Therapeutics • July 1, 2013; (Issue 131)
The text that follows reviews some common bacterial
infections and their empiric treatment pending the
results of culture and susceptibility testing. The recommendations
made here are based on the results...
The text that follows reviews some common bacterial
infections and their empiric treatment pending the
results of culture and susceptibility testing. The recommendations
made here are based on the results of
susceptibility studies, clinical trials, and the opinions
of Medical Letter reviewers. Tables 1 and 2 list the usual
dosages of antibacterial drugs.
Fidaxomicin (Dificid) for Clostridium Difficile Infection
The Medical Letter on Drugs and Therapeutics • September 19, 2011; (Issue 1373)
The FDA has approved fidaxomicin (Dificid – Optimer),
a new oral macrolide antibiotic, for treatment of
Clostridium difficile-associated diarrhea in patients
≥18 years old. The incidence and severity of...
The FDA has approved fidaxomicin (Dificid – Optimer),
a new oral macrolide antibiotic, for treatment of
Clostridium difficile-associated diarrhea in patients
≥18 years old. The incidence and severity of C. difficile
infection (CDI) have increased in recent years with the
emergence of an epidemic hypervirulent strain
(NAP1/B1/027), possibly related to widespread use of
fluoroquinolones.
Treatment of Clostridium Difficile Infection
The Medical Letter on Drugs and Therapeutics • February 21, 2011; (Issue 1358)
Clostridium difficile infection (CDI) is the most common infectious cause of healthcare-associated diarrhea in adults. The incidence and severity of CDI have increased in recent years with the emergence of an...
Clostridium difficile infection (CDI) is the most common infectious cause of healthcare-associated diarrhea in adults. The incidence and severity of CDI have increased in recent years with the emergence of an epidemic virulent strain (NAP1/BI/027). Common risk factors include admission to a healthcare facility, increasing age and severity of underlying illness, gastric acid suppression and exposure to antimicrobials, particularly clindamycin, ampicillin, cephalosporins or fluoroquinolones. Patients who develop CDI while receiving a precipitating antibiotic should have the antibiotic discontinued, if possible, or switched to another appropriate antimicrobial with a lower risk of CDI.
Drugs for Bacterial Infections
The Medical Letter on Drugs and Therapeutics • June 1, 2010; (Issue 94)
The text below reviews some common bacterial infections and their treatment. The recommendations made
here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter...
The text below reviews some common bacterial infections and their treatment. The recommendations made
here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants.
Antimicrobial Prophylaxis for Surgery
The Medical Letter on Drugs and Therapeutics • June 1, 2009; (Issue 82)
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in the...
Antimicrobial prophylaxis can decrease the incidence of infection, particularly surgical site infection, after certain procedures. Recommendations for prevention of surgical site infection are listed in the table that begins on page 48. Antimicrobial prophylaxis for dental procedures to prevent endocarditis is discussed in The Medical Letter 2007; 49:99.
Addendum: Probiotics
The Medical Letter on Drugs and Therapeutics • December 3, 2007; (Issue 1275)
(Vol. 49, p. 66, August 13, 2007) A reader has pointed out that Saccharomyces boulardii is not a separate species, but a strain of Saccharomyces cerevisiae. S. cerevisiae (including S. boulardii) has been...
(Vol. 49, p. 66, August 13, 2007) A reader has pointed out that Saccharomyces boulardii is not a separate species, but a strain of Saccharomyces cerevisiae. S. cerevisiae (including S. boulardii) has been reported to cause systemic infection after oral ingestion in both immunocompromised patients and healthy hosts (MJ McCullough et al. J Clin Microbiol 1998; 36:2613).
Probiotics
The Medical Letter on Drugs and Therapeutics • August 13, 2007; (Issue 1267)
Probiotics are live, nonpathogenic microorganisms (usually bacteria or yeasts) that have been used for centuries for their potential health benefits. They are currently marketed for prevention and treatment of...
Probiotics are live, nonpathogenic microorganisms (usually bacteria or yeasts) that have been used for centuries for their potential health benefits. They are currently marketed for prevention and treatment of a variety of disorders, including diarrhea, irritable bowel syndrome and inflammatory bowel disease.
Choice of Antibacterial Drugs
The Medical Letter on Drugs and Therapeutics • May 1, 2007; (Issue 57)
Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric...
Information about empirical treatment of bacterial infections, emerging trends in antimicrobial resistance, new drugs and new data about older drugs continue to become available. Usual pathogens and empiric treatment for some common types of infections are summarized in the text and a table listing the drugs of choice and alternatives for each pathogen begins on page 40. The recommendations made here are based on the results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants.
Clarification: Hand Hygiene and CDAD
The Medical Letter on Drugs and Therapeutics • January 29, 2007; (Issue 1253)
In the recent Medical Letter article on the treatment of Clostridium difficile–associated disease (CDAD) we wrote: “Healthcare workers caring for patients with C. difficile infection should follow contact...
In the recent Medical Letter article on the treatment of Clostridium difficile–associated disease (CDAD) we wrote: “Healthcare workers caring for patients with C. difficile infection should follow contact isolation precautions, especially use of gloves and hand washing with soap and water after glove removal. Alcohol-based products such as hand sanitizers will not eradicate C. difficile spores.”1 One reader pointed out that alcoholbased products do eradicate some C. difficile spores and have been invaluable against other pathogens.
In an unpublished study available as an abstract, both alcohol-based hand gels and chlorhexidine washes reduced the number of C. difficile spores on contaminated hands, but chlorhexidine was more effective (8 spores/cm2 remaining vs. 30-44 spores/cm2 with 3 formulations of alcohol-based hand gels).2 A previous study showed that chlorhexidine was not different from soap in removal of spores.3 Alcohol itself should have no effect on spores (purified spores are frequently stored in alcohol), but the mechanical action of washing hands with alcohol-based products may be effective in removing them. The CDC has recommended that healthcare workers caring for patients with known or suspected CDAD use contact precautions and perform hand hygiene with either an alcohol-based hand rub or soap and water, except in an outbreak setting, where exclusive use of soap and water should be considered.4
1. Treatment of Clostridium difficile–associated disease (CDAD). Med Lett Drugs Ther 2006; 48:89.
2. J Leischner et al. Effect of alcohol hand gels and chlorhexidine hand wash in removing spores of Clostridium difficile (CD) from hands. Intersci Conf Antimicrob Agent Chemother (ICAAC), Washington, DC 2005, abstract LB-29-2005.
3. K Bettin et al. Effectiveness of liquid soap vs. chlorhexidine gluconate for the removal of Clostridium difficile from bare hands and gloved hands. Infect Control Hosp Epidemiol 1994; 15:697.
4. CDC. Clostridium difficile information for healthcare providers (www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_HCP.html; accessed January 22, 2007).
Download U.S. English
In an unpublished study available as an abstract, both alcohol-based hand gels and chlorhexidine washes reduced the number of C. difficile spores on contaminated hands, but chlorhexidine was more effective (8 spores/cm2 remaining vs. 30-44 spores/cm2 with 3 formulations of alcohol-based hand gels).2 A previous study showed that chlorhexidine was not different from soap in removal of spores.3 Alcohol itself should have no effect on spores (purified spores are frequently stored in alcohol), but the mechanical action of washing hands with alcohol-based products may be effective in removing them. The CDC has recommended that healthcare workers caring for patients with known or suspected CDAD use contact precautions and perform hand hygiene with either an alcohol-based hand rub or soap and water, except in an outbreak setting, where exclusive use of soap and water should be considered.4
1. Treatment of Clostridium difficile–associated disease (CDAD). Med Lett Drugs Ther 2006; 48:89.
2. J Leischner et al. Effect of alcohol hand gels and chlorhexidine hand wash in removing spores of Clostridium difficile (CD) from hands. Intersci Conf Antimicrob Agent Chemother (ICAAC), Washington, DC 2005, abstract LB-29-2005.
3. K Bettin et al. Effectiveness of liquid soap vs. chlorhexidine gluconate for the removal of Clostridium difficile from bare hands and gloved hands. Infect Control Hosp Epidemiol 1994; 15:697.
4. CDC. Clostridium difficile information for healthcare providers (www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_HCP.html; accessed January 22, 2007).
Download U.S. English
Treatment of Clostridium difficile-Associated Disease (CDAD)
The Medical Letter on Drugs and Therapeutics • November 6, 2006; (Issue 1247)
The gram-positive anaerobic bacillus Clostridium difficile is the most common identifiable cause of antibiotic-associated diarrhea. The antibiotics most often implicated have been ampicillin, second and third...
The gram-positive anaerobic bacillus Clostridium difficile is the most common identifiable cause of antibiotic-associated diarrhea. The antibiotics most often implicated have been ampicillin, second and third generation cephalosporins, clindamycin and fluoroquinolones. The emergence in recent years of a new, more toxic epidemic strain (BI/NAP1), possibly related to widespread use of fluoroquinolones, has caused a marked increase in the incidence and severity of C. difficile-associated disease (CDAD).
Treatment of Community-Associated MRSA Infections
The Medical Letter on Drugs and Therapeutics • February 13, 2006; (Issue 1228)
Methicillin-resistant Staphylococcus aureus (MRSA) infections, which have been a concern for many years, previously occurred primarily in hospitalized patients and those recently treated with antibiotics. In...
Methicillin-resistant Staphylococcus aureus (MRSA) infections, which have been a concern for many years, previously occurred primarily in hospitalized patients and those recently treated with antibiotics. In the past few years, there has been an increasing incidence worldwide of community-associated (CA) MRSA infections in patients without recent antibiotic exposure or contact with the healthcare system.
Tigecycline (Tygacil)
The Medical Letter on Drugs and Therapeutics • September 12, 2005; (Issue 1217)
Tigecycline (Tygacil - Wyeth), a derivative of minocycline, is a new intravenous (IV) antibiotic approved for treatment of complicated intra-abdominal and skin and skin-structure...
Tigecycline (Tygacil - Wyeth), a derivative of minocycline, is a new intravenous (IV) antibiotic approved for treatment of complicated intra-abdominal and skin and skin-structure infections.
Choice of Antibacterial Drugs
The Medical Letter on Drugs and Therapeutics • March 1, 2004; (Issue 19)
New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the...
New drugs for bacterial infections and new information about older drugs continue to become available. Empirical treatment of some common bacterial infections is discussed in this article. A table listing the drugs of choice and alternatives for each pathogen begins on page 18. These recommendations are based on results of susceptibility studies, clinical trials and the opinions of Medical Letter consultants. Local resistance patterns should be taken into account. Trade names are listed on page 24.
The Choice of Antibacterial Drugs
The Medical Letter on Drugs and Therapeutics • August 20, 2001; (Issue 1111)
New drugs for treatment of bacterial infections and new information about older drugs continue to become available. Empirical treatment of some infections is discussed and a table listing the drugs of choice...
New drugs for treatment of bacterial infections and new information about older drugs continue to become available. Empirical treatment of some infections is discussed and a table listing the drugs of choice and alternatives for each pathogen are contained in this article. These recommendations are based on results of susceptibility studies, clinical trials and opinions of Medical Letter consultants. Local resistance patterns should be taken into account.
The Choice of Antibacterial Drugs
The Medical Letter on Drugs and Therapeutics • October 22, 1999; (Issue 1064)
Since The Medical Letter last reviewed the choice of drugs for treatment of bacterial infections, a few new drugs and some new information about older drugs have become...
Since The Medical Letter last reviewed the choice of drugs for treatment of bacterial infections, a few new drugs and some new information about older drugs have become available.