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#
1.University of Agronomic Sciences and Veterinary Medicine of Bucharest, 59 Mărăşti Boulevard, 011464, Bucharest, Romania
2.University 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
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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.