Abstract：
In 2021, the American College of Gastroenterology (ACG), the Infectious Diseases Society of America in conjunction with the Society for Healthcare Epidemiology of America (IDSA/SHEA), and the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) published updated clinical practice guidelines (CPGs) for the management of Clostridioides difficile infections. The differences, sometimes subtle, between these guideline recommendations have caused some debate among clinicians. This paper delves into select key recommendations from each respective CPG and analyzes the differences and evidence associated with each. One primary difference between the CPGs is the preference given to fidaxomicin over vancomycin for initial treatment in non-severe and severe disease endorsed by IDSA/SHEA and ESCMID guidelines, while the ACG-sponsored CPGs do not offer a preference. The emphasis on cost effective data was also a noticeable difference between the CPGs and thus interpretation of the available evidence. When using guidelines to help support local practice or institutional treatment pathways, clinicians should carefully balance CPG recommendations with local patient populations and feasibility of implementation, especially when multiple guidelines for the same disease state exist.
摘要：
2021年，美国胃肠病学会（ACG），美国传染病学会与美国医疗保健流行病学学会（IDSA/SHEA）联合，欧洲临床微生物学和传染病学会（ESCMID）发布了最新的艰难梭菌感染管理临床实践指南（CPGs）。的差异，有时微妙，这些指南建议之间引起了临床医生的一些争论.本文深入研究了每个CPG的关键建议，并分析了与之相关的差异和证据。CPGs之间的一个主要区别是，在IDSA/SHEA和ESCMID指南认可的非严重和严重疾病的初始治疗中，非达霉素优于万古霉素。而ACG赞助的CPG不提供优惠。强调具有成本效益的数据也是CPG之间的显着差异，因此对现有证据的解释也是如此。当使用指南来帮助支持当地实践或机构治疗途径时，临床医生应仔细平衡CPG建议与当地患者人群和实施的可行性，特别是当同一疾病状态存在多个指南时。
