Abstract
Reports of fidaxomicin treatment for patients with multiple recurrent Clostridium difficile infections ([mrCDI] ie, more than 2 CDI episodes) indicate symptomatic response to this agent, but 50% have subsequent mrCDI episodes. In an effort to improve outcomes in patients with mrCDI we used novel regimens of fidaxomicin based on strategies used with vancomycin. Of 8 patients who received a 10-day chaser of fidaxomicin given twice daily after a course of vancomycin, 3 (38%) experienced a subsequent recurrence. Two (18%) of 11 patients who completed a 14- to 33-day course of fidaxomicin in a tapering dose experienced a recurrence, both of whom received additional antibiotics before that recurrence. The median symptom-free interval (SFI) after fidaxomicin taper was greater than the median SFI after the most effective prior regimen for those patients (257 days [interquartile range, 280] vs 25 days [interquartile range, 30], respectively; P = .003). A fidaxomicin chaser or taper regimen may be effective in patients with mrCDI, but the number of patients treated is small, and randomized comparative data are not available.
References
Feb 1, 1989·The Journal of Infectious Diseases·S JohnsonD N Gerding
Mar 1, 1997·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·R FeketyM E Mulligan
Jun 2, 2000·Journal of Clinical Microbiology·F BarbutJ C Petit
Jul 24, 2002·The American Journal of Gastroenterology·Lynne V McFarlandChristina M Surawicz
Feb 17, 2007·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stuart JohnsonDale N Gerding
Mar 6, 2007·The Journal of Antimicrobial Chemotherapy·Daniel M MusherRichard J Hamill
Jan 18, 2008·The Journal of Infectious Diseases·Ju Young ChangVincent B Young
Aug 25, 2009·Anaerobe·Stuart JohnsonDale N Gerding
Jan 22, 2010·The New England Journal of Medicine·Israel LowyDonna M Ambrosino
Aug 21, 2010·Microbiology·Gerald W TannockThomas Louie
Feb 4, 2011·The New England Journal of Medicine·Thomas J LouieUNKNOWN OPT-80-003 Clinical Study Group
Aug 17, 2011·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Kathleen M MullaneSherwood L Gorbach
Sep 29, 2011·The Journal of Antimicrobial Chemotherapy·Kevin W GareyHerbert L DuPont
May 19, 2012·Trends in Microbiology·Robert A Britton, Vincent B Young
May 23, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Robert Orenstein
Jul 7, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas J LouieWalter Krulicki
Jul 7, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Oliver A CornelySherwood L Gorbach
Oct 2, 2012·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stuart Johnson, Dale N Gerding
Jan 18, 2013·The New England Journal of Medicine·Els van NoodJosbert J Keller
Mar 7, 2013·The Journal of Antimicrobial Chemotherapy·Stephanie Smeltzer, Ali Hassoun
Sep 10, 2013·Anaerobe·Johan S BakkenJudy A Streit
Oct 8, 2013·PloS One·Turki AbujamelCurtis J Donskey
Citations
Nov 20, 2015·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Caroline Sheitoyan-PesantLouis Valiquette
Jun 17, 2015·The Journal of Antimicrobial Chemotherapy·C H ChiltonM H Wilcox
Jan 13, 2015·Infectious Disease Clinics of North America·Melinda M Soriano, Stuart Johnson
Aug 19, 2016·SpringerPlus·Dhara N ShahKevin W Garey
Dec 25, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stuart Johnson, Dale N Gerding
Mar 14, 2018·Antimicrobial Agents and Chemotherapy·Myreen E TomasCurtis J Donskey
Sep 22, 2018·Annals of the New York Academy of Sciences·Michael G DieterleVincent B Young
Jan 9, 2019·Wiener klinische Wochenschrift·Daniela KnaflFlorian Thalhammer
Jan 25, 2020·Expert Review of Anti-infective Therapy·Adriana M RauseoErik R Dubberke
Oct 28, 2019·Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation·Blake Victor KentAlexandra E Shields
Apr 9, 2020·Expert Review of Anti-infective Therapy·Elida Voth, Sahil Khanna
Oct 5, 2019·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Christopher A Schriever, Larry H Danziger
Jul 4, 2020·Current Opinion in Organ Transplantation·Darren Wong, Neha Nanda
Aug 27, 2019·Therapeutic Advances in Infectious Disease·Robert Orenstein, Roberto L Patron
Jan 1, 2015·Antibiotics·Eric WenzlerLarry H Danziger
Jan 20, 2017·PloS One·Emilie BaroBenoit Dervaux
Jun 8, 2017·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Benjamin D SirbuStuart Johnson
Jul 1, 2020·American Journal of Physiology. Gastrointestinal and Liver Physiology·Xi QianCheleste M Thorpe
Jul 1, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stuart Johnson
May 21, 2019·Therapeutic Advances in Gastroenterology·Srishti Saha, Sahil Khanna
Apr 20, 2019·Clinical Transplantation·Kathleen M MullaneUNKNOWN AST ID Community of Practice
May 11, 2018·The Journal of Hospital Infection·D A EnochN M Brown
Jun 6, 2021·Mayo Clinic Proceedings·Sahil KhannaDarrell S Pardi
Jun 25, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Stuart JohnsonMark H Wilcox
Mar 15, 2021·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Andrew M SkinnerStuart Johnson