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Войти в исследования The Annals of pharmacotherapy · 2025
Partial Courses of Fidaxomicin Followed by Oral Vancomycin and the Effect on Recurrence of Clostridioides difficile Infections.
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Papamanolis Irene-Constantina, Stornelli Nicholas, Everson Nathan, Ahmad Zayd, Kamrada Meghan, Lockhart Ellen Rachel, McDaniel Lauren
Аннотация
BACKGROUND: Clostridioides difficile infection (CDI) causes a significant national health care burden. Literature has demonstrated lower rates of CDI recurrence with fidaxomicin compared with oral vancomycin. However, patients are sometimes switched to oral vancomycin before completing a fidaxomicin course.
OBJECTIVE: The objective of this study is to evaluate rates of CDI recurrence in full courses of fidaxomicin versus partial courses of fidaxomicin followed by a switch to oral vancomycin.
METHODS: In this single-center, retrospective, cohort study of adults with CDI, patients were screened for inclusion if they received either a full 10-day course of fidaxomicin or partial course of fidaxomicin followed by a switch to oral vancomycin. The primary outcome was the rate of CDI recurrence within 30 days after completion of initial therapy determined by a positive CDI test and initiation of treatment.
RESULTS: Ninety-nine patients received a full course of fidaxomicin, and 95 patients received a partial course of fidaxomicin followed by oral vancomycin. Mean age was lower in the full course group compared with the partial course (65.3 years vs 71.5 years, P < 0.002). Clostridioides difficile infection recurrence occurred in 5.1% of the full course group and 7.4% of the partial therapy group (P = 0.503) at 30 days and 13.1% versus 14.7% (P = 0.747) at 90 days. Clostridioides difficile infection-related readmissions at 30 days were similar in the full course and partial course groups (7.1% vs 4.2%, P = 0.389).
CONCLUSION AND RELEVANCE: Partial courses of fidaxomicin followed by oral vancomycin had similar 30-day CDI recurrence compared with full course fidaxomicin.
OBJECTIVE: The objective of this study is to evaluate rates of CDI recurrence in full courses of fidaxomicin versus partial courses of fidaxomicin followed by a switch to oral vancomycin.
METHODS: In this single-center, retrospective, cohort study of adults with CDI, patients were screened for inclusion if they received either a full 10-day course of fidaxomicin or partial course of fidaxomicin followed by a switch to oral vancomycin. The primary outcome was the rate of CDI recurrence within 30 days after completion of initial therapy determined by a positive CDI test and initiation of treatment.
RESULTS: Ninety-nine patients received a full course of fidaxomicin, and 95 patients received a partial course of fidaxomicin followed by oral vancomycin. Mean age was lower in the full course group compared with the partial course (65.3 years vs 71.5 years, P < 0.002). Clostridioides difficile infection recurrence occurred in 5.1% of the full course group and 7.4% of the partial therapy group (P = 0.503) at 30 days and 13.1% versus 14.7% (P = 0.747) at 90 days. Clostridioides difficile infection-related readmissions at 30 days were similar in the full course and partial course groups (7.1% vs 4.2%, P = 0.389).
CONCLUSION AND RELEVANCE: Partial courses of fidaxomicin followed by oral vancomycin had similar 30-day CDI recurrence compared with full course fidaxomicin.