Clostridium-difficile-assozierte Kolitis – Neue Entwicklungen

Was ist neu

Epidemiologie Seit 2016 gilt eine erweiterte Meldepflicht.

Klinik und Risikofaktoren Cephalosporine und Protonenpumpenhemmer (PPI)-Therapie erhöhen das Risiko.

Diagnostik Immuntests (Antigen und Toxin im Stuhl) machen eine rasche Diagnose möglich.

Therapie Leitlinien empfehlen eine abgestufte Therapie nach Schweregrad und Rezidiv (-risiko). Mit Bezlotoxumab ist ein neuer Antikörper zur Prävention von Rezidiven zugelassen. In Metaanalysen zeigt sich eine leichte Überlegenheit von Fidaxomicin gegenüber Vancomycin und Metronidazol.

Prophylaxe und Hygiene Antibiotika-Stewardship kann die Inzidenz um 50 %, Probiotikagabe sogar um 60 % senken.

• Literatur

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