Results of Comparative Study of Macrolide Group Antibiotics Consumption in Ukraine, Russia and Kazakhstan

Abstract

The main aim of this systematic review was to analyse and compare the clinical efficacy and safety of metronidazole, vancomycin and fidaxomicin in the therapy of C. difficile infection. Methods: Systematic review and meta-analysis of the literature using Bayesian mixed treatment comparison. Results: Nine studies were included in the mixed-treatment comparison. Our meta-analysis showed that clinical cure was more likely with fidaxomicin compared to vancomycin and metronidazole, however the differences were not significant. (odds ratios [95% CI]: fidaxomicin vs. vancomycin 1.19 [0.82-1.66]; vancomycin vs. metronidazole 1.69 [0.93-2.82] and fidaxomicin vs. metronidazole 2.00 [0.99-3.66]). Fidaxomicin therapy was significantly more efficacious than vancomycin and metronidazole in endpoints of recurrence (odds ratios [95% CI]: fidaxomicin vs. vancomycin 0.47 [0.33-0.65]; vancomycin vs. metronidazole 0.91 [0.44-1.69] and fidaxomicin vs. metronidazole 0.43 [0.19-0.85]) and sustained cure (odds ratios [95% CI]: fidaxomicin vs. vancomycin 1.77 [1.35-2.28]; vancomycin vs. metronidazole 1.49 [0.92-2.30]; and fidaxomicin vs. metronidazole 2.64 [1 .50-4.35]. There was no significant difference between fidaxomicin, vancomycin and metronidazole in safety endpoints. ConClusions: Fidaxomicin was the most efficacious therapeutic alternative in lowering the rate of recurrent C. difficile infections.objeCtives: C. difficile is the leading cause of antibiotic associated infectious nosocomial diarrhoea. A limited number of new pharmaceutical products have been developed and registered in past decades for the treatment of C. difficile infection.