Safety and efficacy of fidaxomicin in the treatment of Clostridium difficile-associated diarrhea

Abstract

Clostridium difficile-associated diarrhea (CDAD) is the most common cause of healthcare-associated diarrhea. The current recommended treatment regimens of metronidazole and vancomycin have not changed in nearly 25 years. Fidaxomicin, an exceedingly narrow spectrum macrolide antibiotic, was recently approved for the treatment of CDAD. In phase III clinical trials, fidaxomicin was noninferior to vancomycin in achieving clinical cure of CDAD. Furthermore, fidaxomicin was associated with fewer recurrences of CDAD compared with vancomycin in clinical trials. These results, combined with the ease of administration and a good safety profile, make fidaxomicin an attractive treatment option for treating CDAD.

Fidaxomicin Inhibits Clostridium difficile Toxin A-Mediated Enteritis in the Mouse Ileum

“…difficile mediates CDI and intestinal inflammation by a mechanism involving the release of two potent exotoxins, toxin A and toxin B (1,23). Fidaxomicin is a new antibiotic member of the macrolide family (24), recently approved by the FDA for use against CDI (25). Although its efficacy is similar to that of vancomycin, the use of fidaxomicin is associated with fewer recurrent episodes of CDI (6).…”

Coste de la diarrea asociada a Clostridium difficile en España

“…Recientemente se ha comercializado la Fidaxomicina, una nueva clase de antibiótico macrólido, aproximadamente 8 veces más activo in vitro que la Vancomicina frente a las cepas de Clostridium difficile, con una mínima absorción sistémica, que alcanza altas concentraciones fecales 24 . Este antibiótico no se incluyó en el presente estudio debido a que se comercializó con posterioridad a la realización del presente trabajo.…”

Persistent and Recurrent Clostridium difficile Colitis

“…10 Its narrow spectrum, active against C. difficile and most staphylococci and enterococci, proves useful as it has minimal activity against gramnegatives and may help support gut flora in rebuffing recurrence. 11,12…”