Clostridium difficile infection (CDI) is a potential life-threatening consequence of
antibiotic therapy. Although the risk increases with
duration of treatment, it can also occur after a short treatment course. In addition to broad-spectrum
antibiotics, anti-neoplastic agents,
proton pump inhibitors, H(2) blockers, and several other drugs have been reported to induce intestinal
dysbiosis, which is central to the pathogenesis of CDI. There is an increase in incidence and mortality attributed to CDI globally. Moreover, the epidemiology of C. difficile-associated diseases has changed significantly with an increasing occurrence of community-acquired CDI.
Metronidazole and oral
vancomycin are the first-line
antibiotics used to treat CDI. However,
metronidazole has limited effectiveness in severe cases and
vancomycin use is associated with increasing risk of vancomycin resistance among Enterococcus spp.
Cadazolid, a novel
oxazolidinone antibiotic, has recently shown potent antimicrobial activity against C. difficile and has a lower propensity to induce resistance. The implications of its use in treating CDI have been reviewed based on current evidence.