Chemoprophylaxis in the prevention of Clostridium difficile infection: Still a ways to go

摘要

Clostridium difficile infection (CDI) in hospitalized patients is an event with a high impact on morbidity and mortality, as well as on healthcare costs. With respect to this, the Revista de Gastroenterología de México consistently publishes important articles written by medical personnel with different degrees of training. As part of ECOS 2016, Icaza-Chavez's paper “Current Information on Clostridium difficile infection” was published.1 It contained notes on interesting developments in the treatment of that pathology, most of which correlated with later publications. However, in the Prevention section, he cited the work of Fischer et al.2 that was presented at an oral session of the 2016 Digestive Disease Week, and somewhat unclearly, concluded that a reduced risk for presenting with CDI could not be demonstrated through antibiotic use. What Fischer et al. had indeed stated was that in patients with successful fecal microbiota transplant, recurrence associated with antibiotic use not directed at CDI treatment was low (6.5% [6/152]); they did not describe antibiotic use directed at CDI treatment (vancomycin and metronidazole), or the use of probiotics, as either a success or failure.