Medical treatment of Clostridium difficile-related gastrointestinal infection - whither vancomycin?

Abstract

One of the major advances in anaerobic microbiology in the past few decades has been clarifing the causal relationship between Clostridium difficile and pseudomembranous colitis, and its association with previous antimicrobial therapy. It is now clear that C. difficile is responsible for virtually all cases of pseudomembranous colitis and up to 20% of cases of antibiotic-associated diarrhoea. Clindamycin is widely recognised for its propensity to induce these diseases, but broad-spectrum penicillins and cephalosporins (reflecting their widespread usage) are much more common precipitating agents.