Evaluation of fidaxomicin use in community hospitals after a clinical guideline change at a large health system and opportunities for stewardship

Abstract

After updating our health system’s Clostridioides difficile treatment protocols in 2018, we reviewed 104 unique hospital encounters involving fidaxomicin at 10 community hospitals. Half (50%) of regimens were adherent to our guidelines, with infectious diseases (ID) providers were frequently nonadherent. Antimicrobial stewardship programs are important for facilitating best practices, even among ID specialists.

Clustering Disease of Clostridioides Difficile Infection: Implication for the Management in Internal Medicine

“…In fact, the price of a 10-day treatment scheme with metronidazole is minimal compared to 10 days of treatment with vancomycin, while the use of fidaxomicin is over EUR 1000 if we consider the same duration of treatment. However, it is important to know that the latter drug is more effective both in treating an initial episode of CDI and significantly reducing the rate of relapses [189][190][191]. A German study [192] also reached the same conclusions, demonstrating that among conventional first-line treatments, fidaxomicin was found to be cost-effective compared to other drugs and this result can be attributed to the lower rate of CDI relapses.…”