Wiedel Noah, Gilbert Jorge, Baloun Brett, Nelson Chelsea
S D Med. 2016 Mar;69(3):124-7.
Clostridium difficile associated diarrhea (CDAD) is increasingly important in primary care, and associated with high cost, significant morbidity and mortality. As the preferred treatment for different groups of patients varies considerably, it is important to stratify CDAD patients into mild versus severe and uncomplicated versus complicated. While treatment with either metronidazole or oral vancomycin cures a majority of patients, and despite improvement in early diagnosis and therapy, recurrence continues to be a significant problem. In appropriately selected patients, fecal bacteriotherapy has emerged as an effective treatment for the patient with multiple recurrences. Addressing CDAD should include antibiotic stewardship, improved hygiene, prompt diagnosis, appropriate treatment, and infection precautions in hospitals and skilled nursing facilities.
艰难梭菌相关性腹泻（CDAD）在初级保健中日益重要，且与高成本、显著的发病率和死亡率相关。由于不同患者群体的首选治疗方法差异很大，因此将CDAD患者分为轻度与重度、非复杂性与复杂性很重要。虽然甲硝唑或口服万古霉素治疗可治愈大多数患者，且尽管早期诊断和治疗有所改善，但复发仍然是一个重大问题。在适当选择的患者中，粪便细菌疗法已成为治疗多次复发患者的有效方法。应对CDAD应包括抗生素管理、改善卫生状况、及时诊断、适当治疗以及医院和专业护理机构的感染预防措施。
