On August 10, 2023, the American Academy of Pediatrics published an updated review of Epidemiology, Diagnosis, and Therapy of C. diff Infections (CDI) in pediatric patients. The review noted that CDI in children has steadily increased over the past 3 decades, with 20,000 cases now reported annually in the US.

“In contrast to infection in adults, CDI in children is more commonly community-associated, accounting for three-quarters of all cases. A wide spectrum of disease severity ranging from asymptomatic carriage to severe diarrhea can occur, varying by age.”

The review went on to note that recurrence within 60 days occurs in approximately 30% of pediatric CDI cases. Treatment options for recurrent CDI in children remains limited. Vancomycin and metronidazole remain the standard of care for children while fidaxomicin has just started to be used more often. Recently approved microbiome therapeutics have not been studied or approved for pediatric use.

“Prevention of CDI is an important goal to protect children and limit healthcare costs. In the absence of a safe and effective vaccine, prevention strategies rely on a 2-pronged approach of prevention of spread of C. difficile spores and prevention of factors that promote progression to disease in those with established colonization.”

The review concluded that significant knowledge gaps remain  in understanding the epidemiology and treatment of CDI in children. You can read the full review here.