Clostridium difficile or Clostridioides difficile (C. difficile)
infection represents the most common cause of
healthcare-associated infection. Over the last decades, the incidence and severity of C. difficile
infection is rapidly increasing, with a significant impact on morbidity and mortality, and burden on health care system. Orally administered
vancomycin and
fidaxomicin are the therapeutic options of choice for initial C. difficile
infection and
fecal microbiota transplant for the recurrence
infection. Furthermore, in recent years several new
antibiotics with narrow-spectrum activity and low intestinal resorption have been developed, including
surotomycin,
cadazolid, and ridinilazol, and novel
toxoid vaccines are expected to be efficacious in the prevention of C. difficile
infection. Areas covered: Literature review was performed to select publications about current guidelines and phase-II/III trials on emerging drugs. These include novel
antibiotics,
monoclonal antibodies,
vaccines, and
fecal microbiota transplantation. Expert opinion: We have today a wide spectrum of promising therapeutic possibilities against
infection. Pivotal future clinical trials may be crucial in developing effective strategies to optimize outcomes, mainly in high-risk population.