STUDY OBJECTIVE: To evaluate real-world clinical and economic outcomes in patients with Clostridium difficile infection (CDI) treated with fidaxomicin. DESIGN: Retrospective case series. SETTING: Academic medical center. PATIENTS: A total of 61 patients with CDI who were treated with fidaxomicin monotherapy or combination therapy from September 2011 to December 2012. MEASUREMENTS AND MAIN RESULTS: Data on demographics, infection characteristics, and clinical and economic outcomes were evaluated. Clinical cure was defined as resolution of diarrhea (less than or equal to three unformed stools for at least 2 consecutive days) maintained for the duration of therapy with no further requirement for CDI therapy and was achieved in 44 (72.1%) patients. Clinical cure was significantly higher for patients receiving fidaxomicin monotherapy compared with fidaxomicin combination therapy (25/29 [86.2%] patients vs 19/32 [59.4%] patients, p=0.04). Clinical cure was similar in patients with a first or prior CDI episode (65.5% vs 78.1%, p=0.27) and in patients with severe versus nonsevere disease (68.4% vs 73.8%, p=0.66). Recurrence occurred in 6 (13.6%) of the 44 patients who achieved clinical cure. Mortality attributable to CDI was 11.5%, and 30-day readmission rate was 4.9%. Median cost accrued during CDI was $19,483/patient. CONCLUSION: Our real-world experience with fidaxomicin significantly differs from the findings of phase III clinical trials. Fidaxomicin is also associated with substantial costs. Multicenter studies are needed to determine the optimal role of fidaxomicin in the treatment of CDI.
STUDY OBJECTIVE: To evaluate real-world clinical and economic outcomes in patients with Clostridium difficile infection (CDI) treated with fidaxomicin. DESIGN: Retrospective case series. SETTING: Academic medical center. PATIENTS: A total of 61 patients with CDI who were treated with fidaxomicin monotherapy or combination therapy from September 2011 to December 2012. MEASUREMENTS AND MAIN RESULTS: Data on demographics, infection characteristics, and clinical and economic outcomes were evaluated. Clinical cure was defined as resolution of diarrhea (less than or equal to three unformed stools for at least 2 consecutive days) maintained for the duration of therapy with no further requirement for CDI therapy and was achieved in 44 (72.1%) patients. Clinical cure was significantly higher for patients receiving fidaxomicin monotherapy compared with fidaxomicin combination therapy (25/29 [86.2%] patients vs 19/32 [59.4%] patients, p=0.04). Clinical cure was similar in patients with a first or prior CDI episode (65.5% vs 78.1%, p=0.27) and in patients with severe versus nonsevere disease (68.4% vs 73.8%, p=0.66). Recurrence occurred in 6 (13.6%) of the 44 patients who achieved clinical cure. Mortality attributable to CDI was 11.5%, and 30-day readmission rate was 4.9%. Median cost accrued during CDI was $19,483/patient. CONCLUSION: Our real-world experience with fidaxomicin significantly differs from the findings of phase III clinical trials. Fidaxomicin is also associated with substantial costs. Multicenter studies are needed to determine the optimal role of fidaxomicin in the treatment of CDI.
Authors: C Fehér; E Múñez Rubio; P Merino Amador; A Delgado-Iribarren Garcia-Campero; M Salavert; E Merino; E Maseda Garrido; V Díaz-Brito; M J Álvarez; J Mensa Journal: Eur J Clin Microbiol Infect Dis Date: 2016-10-08 Impact factor: 3.267
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Authors: Dhara N Shah; Fay S Chan; Nandita Kachru; Krutina P Garcia; Holly E Balcer; April P Dyer; John E Emanuel; Michelle D Jordan; Katherine T Lusardi; Geri Naymick; Radhika S Polisetty; Lanny Sieman; Ashley M Tyler; Michael L Johnson; Kevin W Garey Journal: Springerplus Date: 2016-08-02
Authors: Massimo Sartelli; Stefano Di Bella; Lynne V McFarland; Sahil Khanna; Luis Furuya-Kanamori; Nadir Abuzeid; Fikri M Abu-Zidan; Luca Ansaloni; Goran Augustin; Miklosh Bala; Offir Ben-Ishay; Walter L Biffl; Stephen M Brecher; Adrián Camacho-Ortiz; Miguel A Caínzos; Shirley Chan; Jill R Cherry-Bukowiec; Jesse Clanton; Federico Coccolini; Maria E Cocuz; Raul Coimbra; Francesco Cortese; Yunfeng Cui; Jacek Czepiel; Zaza Demetrashvili; Isidoro Di Carlo; Salomone Di Saverio; Irina M Dumitru; Christian Eckmann; Edward H Eiland; Joseph D Forrester; Gustavo P Fraga; Jean L Frossard; Donald E Fry; Rita Galeiras; Wagih Ghnnam; Carlos A Gomes; Ewen A Griffiths; Xavier Guirao; Mohamed H Ahmed; Torsten Herzog; Jae Il Kim; Tariq Iqbal; Arda Isik; Kamal M F Itani; Francesco M Labricciosa; Yeong Y Lee; Paul Juang; Aleksandar Karamarkovic; Peter K Kim; Yoram Kluger; Ari Leppaniemi; Varut Lohsiriwat; Gustavo M Machain; Sanjay Marwah; John E Mazuski; Gokhan Metan; Ernest E Moore; Frederick A Moore; Carlos A Ordoñez; Leonardo Pagani; Nicola Petrosillo; Francisco Portela; Kemal Rasa; Miran Rems; Boris E Sakakushev; Helmut Segovia-Lohse; Gabriele Sganga; Vishal G Shelat; Patrizia Spigaglia; Pierre Tattevin; Cristian Tranà; Libor Urbánek; Jan Ulrych; Pierluigi Viale; Gian L Baiocchi; Fausto Catena Journal: World J Emerg Surg Date: 2019-02-28 Impact factor: 5.469