Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA)

TLDR

Since the 1995 SHEA position paper, the epidemiology and treatment of Clostridium difficile infection have changed markedly, with the pathogen remaining the leading cause of healthcare‑associated diarrhea, emerging as a community threat, and a more virulent strain driving more severe disease, yet controversies persist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management. The guideline synthesizes current evidence to revise recommendations on epidemiology, diagnosis, treatment, and infection control, including environmental management. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published.

Abstract

Since publication of the Society for Healthcare Epidemiology of America position paper on Clostridium difficile infection in 1995, significant changes have occurred in the epidemiology and treatment of this infection. C. difficile remains the most important cause of healthcare-associated diarrhea and is increasingly important as a community pathogen. A more virulent strain of C. difficile has been identified and has been responsible for more-severe cases of disease worldwide. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published. Despite the increasing quantity of data available, areas of controversy still exist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management.