Open AccessFidaxomicin in the treatment of colitis due to Clostridium difficile: preliminary results
Author(s) -
Francesco Cortese,
Marcello Meledandri,
Milva Ballardini,
Anna Ferrari
Publication year - 2014
Publication title -
clinical management issues
Language(s) - English
Resource type - Journals
eISSN - 2283-3137
pISSN - 1973-4832
DOI - 10.7175/cmi.v8i1s.956
Subject(s) - fidaxomicin , medicine , clostridium difficile , diarrhea , antibiotics , metronidazole , clostridium difficile colitis , colitis , vancomycin , colectomy , antibiotic associated diarrhea , gastroenterology , ulcerative colitis , incidence (geometry) , enterocolitis , fecal bacteriotherapy , microbiology and biotechnology , disease , bacteria , physics , optics , biology , genetics , staphylococcus aureus
The incidence of Clostridium difficile infections (CDI) and Clostridium difficile-Associated Diarrhea (CDAD) is increasing in Canada, USA, and Europe and represents a considerable clinical problem. Both naïve and hypervirulent strains can be considered as opportunistic bacteria affecting immunocompromised, antibiotic-treated, critical, or subcritical patients with a microbiota disruption. CDI arising is strictly related to antibiotic, single or combined, and/or proton pump inhibitor treatment. CDI can cause a syndrome with systemic involvement and complex treatment, sometimes requiring surgical interventions (e.g. colectomy in fulminant colitis). Antibiotic treatment with metronidazole by mouth is the first choice and generally vancomycin is administered in case of lack of effectiveness. Fidaxomicin is a new macrocyclic antibiotic for C. difficile with microflora-sparing properties. This paper reports our initial experience in 11 patients with non-responder or relapsing CDIs. Fidaxomicin was effective in 10 cases (91%). Only one patient with an active ulcerative colitis did not respond and was treated with fecal-microbiota transplantation. In two patients diarrhea persisted, but just the ulcerative colitis one was C. difficile-related. No adverse events were experienced.