A prospective, observational study of fidaxomicin use for Clostridioides difficile infection in France.
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Guery Benoit, Berger Pierre, Gauzit Remy, Gourdon Magali, Barbut Frédéric, DAFNE study group, Dafne Study Group, Bémer Pascale, Bessède Emilie, Camou Fabrice, Cattoir Vincent, Couzigou Carine, Descamps Dominique, Dinh Aurélien, Laurans Caroline, Lavigne Jean-Philippe, Lechiche Catherine, Leflon-Guibout Véronique, Le Monnier Alban, Levast Marion, Mootien Joy Yoganaden, N'Guyen Yohan, Piroth Lionel, Prazuck Thierry, Rogeaux Olivier, Roux Anne-Laure, Vachée Anne, Vernet Garnier Véronique, Wallet Frédéric
Аннотация
METHODS: This prospective, multicentre, observational study (DAFNE) enrolled hospitalised patients with CDI, including 294 patients treated with fidaxomicin (outcomes recorded over a 3-month period) and 150 patients treated with other CDI therapies during three 1-month periods. The primary endpoint was baseline and CDI characteristics of fidaxomicin-treated patients.
RESULTS: At baseline, the fidaxomicin-treated population included immunocompromised patients (39.1%) and patients with severe (59.2%) and recurrent (36.4%) CDI. Fidaxomicin was associated with a high rate of clinical cure (92.2%) and low CDI recurrence (16.3% within 3 months). Clinical cure rates were ≥90% in patients aged ≥65 years, those receiving concomitant antibiotics and those with prior or severe CDI. There were 121/296 (40.9%) patients with adverse events (AEs), 5.4% with fidaxomicin-related AEs and 1.0% with serious fidaxomicin-related AEs. No fidaxomicin-related deaths were reported.
CONCLUSIONS: Fidaxomicin is an effective and well-tolerated CDI treatment in a real-world setting in France, which included patients at high risk of adverse outcomes.Trial registration: Description of the use of fidaxomicin in hospitalised patients with documented Clostridium difficile infection and the management of these patients (DAFNE), NCT02214771, www.ClinicalTrials.gov.