Thabit Abrar K, Aljedaani Huda J, Alghamdi Rawan H, Badahdah Raghad M, Lashkar Manar O, Alnajjar Abeer
Department of Pharmacy Practice, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Saudi Arabia.
Department of Pharmaceutical Care, King Khalid Hospital, Ministry of Health, Najran, Saudi Arabia.
Expert Rev Gastroenterol Hepatol. 2023 Jul-Dec;17(8):805-810. doi: 10.1080/17474124.2023.2240704. Epub 2023 Jul 26.
Clostridioides difficile infection (CDI) is a major cause for antibiotic-associated diarrhea. Specific factors put the pediatrics at risk. International guidelines lists specific recommendations for the diagnosis and treatment of pediatric CDI. The practice of diagnosing and treating pediatric CDI in Saudi Arabia is slightly different from the recommendations of the guidelines.
This review summarizes pediatric CDI in Saudi Arabia in terms of epidemiology, current diagnostics, and how the practice compares to recommendations of the guidelines, and available treatment options.
Although pediatric CDI epidemiology in Saudi Arabia doesn't impose a burden on the healthcare system, it should be noted that not all hospitals follow CDI diagnostic recommendations of international guidelines, which may result in cases underreporting. However, due to the presumed low CDI prevalence, the traditional regimen of oral metronidazole for non-severe CDI remains effective, whereas vancomycin is used for severe cases. While fidaxomicin is approved for pediatrics, its high acquisition cost and low CDI rates make it challenging for hospitals to use it. Overall, pediatrics at risk of CDI recurrence should be evaluated, such as reviewing current antibiotics for potential discontinuation. Future studies evaluating the epidemiology and treatment for CDI in Saudi children are needed.
艰难梭菌感染（CDI）是抗生素相关性腹泻的主要原因。特定因素使儿科患者面临风险。国际指南列出了儿科CDI诊断和治疗的具体建议。沙特阿拉伯儿科CDI的诊断和治疗实践与指南建议略有不同。
本综述从流行病学、当前诊断方法、实践与指南建议的比较以及可用治疗方案等方面总结了沙特阿拉伯的儿科CDI。
尽管沙特阿拉伯的儿科CDI流行病学未给医疗系统带来负担，但应注意并非所有医院都遵循国际指南的CDI诊断建议，这可能导致病例报告不足。然而，由于推测CDI患病率较低，非严重CDI的传统口服甲硝唑方案仍然有效，而万古霉素用于严重病例。虽然非达霉素已获批用于儿科，但因其获取成本高且CDI发病率低，医院使用起来具有挑战性。总体而言，应评估有CDI复发风险的儿科患者，例如审查当前使用的抗生素以考虑是否可能停用。未来需要开展评估沙特儿童CDI流行病学和治疗方法的研究。
