Fidaxomicin: A Milestone in the Treatment of Clostridium difficile Infections New Perspectives (original) (raw)

Journal of Research in Medical Education & Ethics, 2012

Abstract

Clostridium difficile (C.difficile) is the major cause of antibiotic associated pseudomembranous colitis (PMC) and has surpassed Methicillin resistant Staphylococcus aureus to become the leading cause of nosocomial infections. The management of PMC involves stopping the causative agent but recurrence is a major problem. Currently, vancomycin and metronidazole are the mainstay of treatment but a recurrence rate of 25–30% after their use has been reported. Moreover, hypervirulent strains, reduced susceptibility and resistance to metronidazole further complicate the treatment. Fidaxomicin is a narrow spectrum macrocyclic antibiotic recently approved by FDA for treatment of Clostridium difficile infections. Comparative Phase 3 trials with vancomycin showed fidaxomicin to be equal to vancomycin in terms of achieving clinical cure rates but superior in terms of having lower recurrence rates and global cure rates. Lower recurrence is attributed to preservation of normal microflora by fidaxomicin. Most common side effects are gastrointestinal (GI) disorders and general disorders. Safety and efficacy of fidaxomicin prove it to be a welcome addition to existing armamentarium to combat Clostridium difficile.

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