NATURAL ALTERNATIVE REMEDIES IN THE BACKGROUND OF
UPDATED RECOMMENDATIONS FOR THE PROPHYLACTIC AND
THERAPEUTIC APPROACH OF CLOSTRIDIUM DIFFICILE INFECTIONS
MARA GEORGESCU 1#, OCTAV GINGHINĂ 2,3#*, ȘTEFANIA RAITA 1#, DANA TĂPĂLOAGĂ 1#, LUCIAN ILIE 1#, CAROLINA NEGREI 2#, DANIELA ELENA POPA 2#, VALENTIN VARLAS 2#, RĂZVAN MULȚESCU 3#, ADRIAN COSMIN ROȘCA 4#, RADU MIRICĂ 3#, DRAGOȘ GEORGESCU 2,3#
1University of Agronomic Sciences and Veterinary Medicine of Bucharest, 59 Mărăşti Boulevard, 011464, Bucharest, Romania
2University of Medicine and Pharmacy "Carol Davila" Bucharest, 37 Dionisie Lupu Street, Bucharest, Romania
3“Sf. Ioan” Clinical Emergency Hospital, 13 Vitan Bărzești Highway, Bucharest, Romania
4“Ovidius” University, 6 Căpitan Av. Al. Șerbănescu Street, Campus, Corp C, Constanța, Romania
*corresponding author: octavginghina@gmail.com
#All authors have equal contribution.
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Abstract:
Clostridium difficile infection (CDI) remains one of the greatest concerns in current worldwide medical practice. Its
incidence, severity and patient susceptibility range have known a steady growth. The antibiotics of choice are associated with
increasing recurrence rates, decreased susceptibility for some strains, the selection of other antibiotic-resistant enteric
pathogens and high cost of treatment, difficult to be supported by the healthcare system. Even if there is a general agreement
over the first choice CDI treatment options, the most important international guidelines are not consistent regarding
alternative treatment options, such as probiotics, intravenous immunoglobulins (IVIG), monoclonal antibodies, novel
antibiotics (fidaxomicin), most of which remaining controversial. Upon consulting international guidelines, numerous
discordant recommendations and unsolved issues are revealed. These differences may be due to the constant evolution of
prevention and management strategies, in the background of emergence of new scientific and novel treatment suggestions.
Many efforts are targeting the discovery of an ideal CDI treatment approach, which would not only eliminate the bacteria and
reduce its toxin production, but also achieve restoration of beneficial intestinal microflora and assist the patient immune
system. Therefore, many off-label, experimental, novel, natural or combination solutions have been addressed in the latest
published research on this matter. In order to assist the potential guidance of future research in this field, this study reviews
the recent literature findings on alternative CDI treatment and prophylaxis options.

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