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Abstract：
OBJECTIVE: Clostridioides difficile infection (CDI) is a widely recognized condition associated with comorbidity and decreased patient quality of life. Certain professional medical organizations develop clinical practice guidelines for major diseases. This is done in an effort to streamline the universal clinical practice and ensure that a more accurate diagnosis and better treatments are offered to respective patients for optimal outcomes. However, as new data evolve, constant update of these guidelines becomes essential. While these guidelines provide up-to-date recommendations, they are not published around the same time; thus, their recommendations may vary depending on evidence available prior to guidelines preparation and publication.
METHODS: Recommendations and corresponding justifications from three major CDI guidelines between 2013 and 2017 were pooled and compared, and notable differences were highlighted while providing an insight and a final recommendation from a clinical standpoint.
RESULTS: Most recommendations were consistent among all three guidelines. One notable difference was in the specification of candidates for CDI diagnosis, where it would be recommended to mainly test patients with three or more diarrheal episodes over 24 h, if they had no other clear reason for the diarrhea. Another conflicting point was regarding the treatment of non-severe CDI where vancomycin can be considered for older or sicker patients; however, metronidazole still remains a reasonable option based on recent data, some of which were not cited in the most recent guidelines of IDSA/SHEA.
CONCLUSIONS: Overall, it is prudent to follow these guidelines with critical appraisal to fulfill the goal of achieving optimum patient outcomes.
METHODS: Recommendations and corresponding justifications from three major CDI guidelines between 2013 and 2017 were pooled and compared, and notable differences were highlighted while providing an insight and a final recommendation from a clinical standpoint.
RESULTS: Most recommendations were consistent among all three guidelines. One notable difference was in the specification of candidates for CDI diagnosis, where it would be recommended to mainly test patients with three or more diarrheal episodes over 24 h, if they had no other clear reason for the diarrhea. Another conflicting point was regarding the treatment of non-severe CDI where vancomycin can be considered for older or sicker patients; however, metronidazole still remains a reasonable option based on recent data, some of which were not cited in the most recent guidelines of IDSA/SHEA.
CONCLUSIONS: Overall, it is prudent to follow these guidelines with critical appraisal to fulfill the goal of achieving optimum patient outcomes.
摘要：
目的：艰难梭菌感染（CDI）是一种公认的与合并症和患者生活质量下降相关的疾病。某些专业医疗机构制定重大疾病的临床实践指南。这样做是为了简化通用临床实践并确保为各自的患者提供更准确的诊断和更好的治疗以获得最佳结果。然而,随着新数据的发展，不断更新这些指导方针变得至关重要。虽然这些指南提供了最新的建议，它们不是在同一时间发布的；因此，他们的建议可能会有所不同，这取决于指南准备和发布之前可用的证据。
方法：汇集并比较了2013年至2017年三个主要CDI指南的建议和相应理由，突出了显著差异,同时从临床角度提供了见解和最终建议.
结果：在所有三个指南中，大多数建议是一致的。一个显着差异是CDI诊断的候选人规格，建议主要测试24小时以上腹泻发作的患者，如果他们没有其他明确的腹泻原因。另一个矛盾点是关于非重度CDI的治疗，万古霉素可以考虑用于老年或病情较重的患者；然而，根据最近的数据，甲硝唑仍然是一个合理的选择，其中一些没有在IDSA/SHEA的最新指南中引用。
结论：总体而言，谨慎的做法是遵循这些指南并进行严格评估,以实现实现最佳患者结局的目标.
方法：汇集并比较了2013年至2017年三个主要CDI指南的建议和相应理由，突出了显著差异,同时从临床角度提供了见解和最终建议.
结果：在所有三个指南中，大多数建议是一致的。一个显着差异是CDI诊断的候选人规格，建议主要测试24小时以上腹泻发作的患者，如果他们没有其他明确的腹泻原因。另一个矛盾点是关于非重度CDI的治疗，万古霉素可以考虑用于老年或病情较重的患者；然而，根据最近的数据，甲硝唑仍然是一个合理的选择，其中一些没有在IDSA/SHEA的最新指南中引用。
结论：总体而言，谨慎的做法是遵循这些指南并进行严格评估,以实现实现最佳患者结局的目标.
