The Medical Letter on Drugs and Therapeutics
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1373
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Fidaxomicin (Dificid) for Clostridium Difficile Infection

The FDA has approved fidaxomicin (Dificid – Optimer), a new oral macrolide antibiotic, for treatment of Clostridium difficile-associated diarrhea in patients ≥18 years old. The incidence and severity of C. difficile infection (CDI) have increased in recent years with the emergence of an epidemic hypervirulent strain (NAP1/B1/027), possibly related to widespread use of fluoroquinolones.

STANDARD TREATMENT — Initial Episode – Oral metronidazole and oral vancomycin have been the drugs of choice for treatment of CDI for many years.1 Oral metronidazole is recommended for initial treatment of mild to moderate CDI. Oral vancomycin is the drug of choice for severe CDI. CDI is generally considered severe when patients have an increase in serum creatinine to ≥1.5 times baseline or a white blood cell count of ≥15,000 cells/mm3. Other risk factors ... more      

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