Fidaxomicin versus Conventional Antimicrobial Therapy in 59 Recipients of Solid Organ and Hematopoietic Stem Cell Transplantation with Clostridium difficile-Associated Diarrhea.
Antimicrob Agents Chemother. 2013 Jul 8;
Authors: Clutter DS, Dubrovskaya Y, Merl MY, Teperman L, Press R, Safdar A
Feasibility of fidaxomicin vs. vancomycin and metronidazole (conventional therapy) was assessed in 59 transplant recipients with 61 episodes of Clostridium difficile-associated diarrhea (CDAD). Overall clinical cure was achieved in 86% of episodes and in 7% infection recurred. Fidaxomicin was well-tolerated. Clinical cures were not significantly different compared with conventional therapy (67% versus 89%, respectively; P= 0.06). Univariate analysis of predictors for lack of clinical cure included continued use of broad-spectrum systemic antibiotics (P = 0.026) and prior diagnosis of CDAD (95% confidence interval, 1.113-19.569; odds ratio, 4.667; P = 0.041). New onset vancomycin resistant Enterococcus (VRE) colonization was not noted after fidaxomicin therapy alone. However, this occurred in 10 of 28 patients (36%) following conventional therapy and 2 of 3 patients with subsequent bacteremia died.
PMID: 23836168 [PubMed - as supplied by publisher]