Fidaxomicin: The Newest Addition to the Armamentarium Against Clostridium difficile Infections

摘要: Abstract Background Fidaxomicin, a macrolide antibiotic, was the first medication for management of Clostridium difficile infections (CDI) to be approved by US Food and Drug Administration in more than 20 years. Objective This article reviews published literature on fidaxomicin CDI, including its chemistry, spectrum activity, pharmacokinetic properties, pharmacodynamics, therapeutic efficacy, adverse events, dosing, administration, pharmacoeconomic considerations. Methods Pertinent English-language reviewed through searches MEDLINE, EMBASE, BIOSIS from 1975 September 2011. Reference lists identified publications abstracts Interscience Conference Antimicrobial Agents Chemotherapy meetings were also reviewed. Search terms included, but not limited to, , difimicin lipiarmycin tiacumicin B OPT-80 spp diarrhea . Results A total 79 10 excluded; 6 review articles 4 that later as articles. Fidaxomicin's vitro profile is favorable compared with oral metronidazole vancomycin, minimum inhibitory concentrations against C are 2 dilutions lower. From Phase III trials, deemed noninferior treatment mild moderate CDI vancomycin. Recurrence rates all strains lower Adverse events associated similar placebo, nausea vomiting being most common. Although no studies have or current price exceeds $2500 (US) per course. Conclusions Reports suggest vancomycin although comparisons exist date. Additionally, improved outcomes relapse recurrent patients who might require concomitant antibiotics. Prospective, randomized comparing well severe should undertaken clarify exact role clinical practice.