CDI - Anion-binding resins

Q: Anion-binding resins are considered an effective alternative treatment in frequently relapsing Clostridioides/Clostridium difficile infection (CDI)? 

A) True

B) False

Answer: B

Tolevamer is a C. difficile specific toxin–binding resin. Despite high expectations from early trial (2006) they failed to show any advantage over traditional vancomycin and metronidazole therapy in subsequent large trial (2014). On the same principle, anion-binding resins i.e., colestipol and cholestyramine were tried but found to have no superior value. They can be used an adjuvant treatments but not as an alternative treatments.

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References:

1. Johnson S, Louie TJ, Gerding DN, et al. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis 2014; 59:345.

2. Louie TJ, Peppe J, Watt CK, et al. Tolevamer, a novel nonantibiotic polymer, compared with vancomycin in the treatment of mild to moderately severe Clostridium difficile-associated diarrhea. Clin Infect Dis 2006; 43:411. 

3. Kreutzer EW, Milligan FD. Treatment of antibiotic-associated pseudomembranous colitis with cholestyramine resin. Johns Hopkins Med J 1978; 143:67.