Fidaxomicin - the new drug for Clostridium difficile infection.
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Date
2015-04
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Abstract
Clostridium difficile is one of the many aetiological agents of antibiotic associated diarrhoea and
is implicated in 15-25 per cent of the cases. The organism is also involved in the exacearbation of
inflammatory bowel disease and extracolonic manifestations. Due to increase in the incidence of C.
difficile infection (CDI), emergence of hypervirulent strains, and increased frequency of recurrence, the
clinical management of the disease has become important. The management of CDI is based on disease
severity, and current antibiotic treatment options are limited to vancomycin or metronidazole in the
developing countries. this review article briefly describes important aspects of CDI, and the new drug,
fidaxomicin, for its treatment. Fidaxomicin is particularly active against C.difficile and acts by inhibition
of RNA synthesis. Clinical trials done to compare the efficacy and safety of fidaxomicin with that of
vancomycin in treating CDI concluded that fidaxomicin was non-inferior to vancomycin for treatment of
CDI and that there was a significant reduction in recurrences. The bactericidal properties of fidaxomicin
make it an ideal alternative for CDI treatment. However, fidaxomicin use should be considered taking
into account the potential benefits of the drug, along with the medical requirements of the patient, the
risks of treatment and the high cost of fidaxomicin compared to other treatment regimens.
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Keywords
clinical trials, Clostridium difficile, cost, diarrhoea, fidaxomicin, hypervirulent strain, recurrences, vancomycin
Citation
Vaishnavi Chetana. Fidaxomicin - the new drug for Clostridium difficile infection. Indian Journal of Medical Research. 2015 Apr; 141(4): 398-407.